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Are you tired of hearing the
phrase self-care isn't selfish?

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If you are a senior leader or healthcare
professional, it's one thing to encourage

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your team to look after themselves,
but if you are giving them permission,

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who's giving you that permission?

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The truth is it often doesn't come
from your boss or your colleagues,

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and in many cases it can't.

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So it's our responsibility
to look after ourselves.

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It really shouldn't be called self-care.

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It should be called necessary care,
which is easier said than done, right?

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This week, Dr. Caroline Walker,
psychiatrist, author and founder of

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the Joyful Doctor, and my co-host in
the Permission to Thrive community,

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makes a well overdue return to the
podcast to talk about what we need

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to give ourselves permission to
do and what happens when we don't.

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If you are feeling guilt and shame over
saying no or setting boundaries, or

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you've noticed yourself putting your own
needs aside, this episode is for you.

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If you're in a high stress, high stakes,
still blank medicine, and you're feeling

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stressed or overwhelmed, burning out or
getting out are not your only options.

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I'm Dr. Rachel Morris, and
welcome to You Are Not a Frog.

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I'm Dr. Caroline Walker and I
am a psychiatrist and therapist

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by background, and I specialize
in the wellbeing of doctors and

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other high stress professionals.

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Wonderful to have you back on the podcast.

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Caroline, you're a, you're
a, I'm gonna say an old face.

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You're not an old face,
you're an old friend.

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and Caroline and I do a lot of work
together, including hosting the

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Permission to Thrive membership
with a, a load of doctors, which is

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really a, a personal professional
development community for doctors.

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Now, I wanted to get Caroline
onto the podcast to talk about

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permission, 'cause you've just
written a book called Permission.

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Caroline On Earth.

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Did you write a book called Permission?

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What do we need permission for?

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Well, uh, I needed permission to write
a book, uh, certainly to start with.

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I, yeah, I've always loved writing
and I think I always had a book in me.

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Uh, but like many doctors and busy
professionals, I got kind of, you know,

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on the conveyor belt with work and
all the different roles in my life.

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Um, and yeah, it was a personal journey
for me actually to stop and give

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myself permission to, to pursue a real
passion, you know, which was writing.

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Uh, why this book?

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Why Permission?

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Well, I, I talk about that
in the book, uh, but I think

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basically it was something I saw.

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Every single time I worked with
a stressed out professional,

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I saw this theme coming up.

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You know, a lack of permission, uh, lack
of permission to go home on time, to say

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no to staff, to look after ourselves,
uh, to be who we really are, um, at work

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So what is it or who is it that
doesn't give us permission?

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it basically, it's ourselves.

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Um, I mean, I think as we grow up
as, as children, as human beings in

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the world, we look to others around
us for permission to start with.

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So we might look to our parents
or teachers at school or our

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friends, you know, to let us know
what it is and isn't okay to do.

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Uh, but gradually as we get older, we, we
start to give ourselves more permission.

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Uh, but then again, when we get into
the world of work, often that reverses

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again, like into, uh, looking at others.

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So we might be in a workplace
where everyone's really, really

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busy and no one's leaving on time.

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So we're looking around as a, you know,
going home time and thinking, well,

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I can't leave 'cause no one else is.

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So often we are looking to others
for permission, but actually the

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key to a happy, healthy, joyful
life is to start to give ourselves

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permission to do what we need to do.

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And if you're not giving yourself
the permission to do what you need to

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do, typically, how does that show up?

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And I know you work with practitioner
health, you work with a lot of,

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patients who are doctors who
haven't given themselves permission.

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Where do you end up if
you, you're chronically not

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giving yourself permission?

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Yeah, it's a great question.

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Um, essentially we end up burnt out.

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You know, I think drip, drip, drip over
time, if we are consistently not meeting

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our needs, if we are not having a good
work life balance, then, you know, we can

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keep that up for a short amount of time.

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But eventually, uh, we all break, right?

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Eventually.

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Uh, if we're running on empty for
too long, then yeah, quite often

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I'll see people who, other areas of
their life has started to fall apart.

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Like maybe their relationships at home are
suffering or their health is suffering,

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but they're just keeping going at work.

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So others around you might not
think there's anything wrong, right?

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They might think you're doing great
'cause you are, you know, achieving a lot.

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You are really reliable.

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Eventually, once every other
area of your life has started to

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fall apart, then work does give.

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And you know, I've seen numerous, uh,
examples where doctors or other high

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stress professionals have just literally
their, like their body or their brain

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has just stopped working one day, so
they literally can't get out bed or

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they're going to type an email and
their hands just stop on the keyboard,

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you know, they can't do it anymore.

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But it's odd, isn't it?

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Because you know, doctors, these
people in high stress jobs and lots

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of senior healthcare professionals,
we know that we need to rest and

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we know that we're not at our best.

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You know, some of it is, you
know, enshrined in, in safety.

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So, you know, if we were a pilot,
we wouldn't be allowed to fly.

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I dunno what the flying, you know, the,
the how long you're allowed to fly window

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is, or the how long you're not allowed
to drink alcohol before you do it.

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Why hasn't that got
through to doctors yet?

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Yeah, another great question.

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I think you, you know, you say we
know it, but I'm not sure we do

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collectively as a group of people.

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I think we know it intellectually and
we know it for others, but we haven't

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yet learned how to do it for ourselves.

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And I, I think it's a mixture of reasons.

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I think one of the main reasons is we're
not role modeled it particularly well.

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I mean, that is getting better as more
and more of us are trying to role model

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more healthy behavior and boundaries.

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But generally speaking, we
don't see other doctors and

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healthcare professionals doing it.

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What we see is people giving and giving
and giving, sacrificing themselves kind of

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slightly, you know, martyring themselves,
um, having that kind of hero mentality,

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you know, we must put others first.

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And we sort of put that up
on a pedestal, don't we?

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And a lot of our self-esteem or
self-worth, um, is driven by that.

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So it's really difficult for us,
I think, to see that it's okay.

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You know, we, the idea of us saying no to
something or going home and there's still

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work to do is, it kind of goes against
our core values as a person quite often.

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And so a lot of the work I do with DOS is
to help 'em to see that that's not true.

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You know, that actually when you do
peel it all apart, you, you have to

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be well in order to do this job well.

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So if you really, genuinely want to
do the best by your patients, then

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you have to look after yourself first.

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It's really hard though, isn't it, when
there's no slack in the system and,

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Totally.

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and if you do look after yourself, that
actually impinges on somebody else.

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It impinges on somebody else, which means
that they can't look after themselves.

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So people are stuck between
a rock and a hard place.

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How do you navigate that?

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Well, it kind of depends
where people are at.

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I mean, as I shared before, we'll often
see people where they're at really

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at breaking point, and at that point
the sort of, it's kind of taken outta

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your hands a little bit, isn't it?

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'Cause if you are so unwell that you
can't go to work, for example, you're

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gonna have to take some time off,
then that does at least give you a bit

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of breathing space and a bit of time
to kind of work through this stuff

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and to realize how important it is.

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If someone's not that unwell, let's
say you've just noticed that you're

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starting to get a bit more tired,
or you're starting to notice some

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warning signs, um, that you're not at
your best, then we would start a bit

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more, a bit more gentle, a bit slower.

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We just start with some small
changes that are doable.

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You know, I think the really
important thing about this is not,

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not to get too fancy about it, but
just to be, start really, really

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simple and really straightforward.

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So, you know, if you're leaving
late, could you leave like 15

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minutes earlier than you have been?

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Or, you know, if you are saying
yes to 10 things, could you say

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no to just one of those 10 things?

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You know, so we start with really
small changes and, and that kind of

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tends to build people's confidence
over time because then it's like,

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okay, well the, the sky didn't
fall down, you know, nobody died.

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It was okay, maybe I could do that again
tomorrow, and then we build from there.

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Do you think that the people you
see are waiting on permission

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from other people as well?

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Definitely.

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Yeah, and I think we're, as
I say, we're trained to do

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that even as children, right?

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We're trained to look towards
adults to tell us how to behave.

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Um, and then as you know, uh, doctors or
whatever profession you're in, you will

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have looked to those that have gone before
you to see what is it okay for me to do

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and what is it not okay for me to do?

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Um, so, and that's quite normal.

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But the problem is if we just keep
doing that on automatic pilot, that

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we are not gonna get our needs met,
we are not gonna make those decisions

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that we need to make to keep well and
to stay well and to avoid burnout.

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So, yes, whilst it's quite normal
and, um, common for us to look to

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others for permission, and that's
okay, um, we've also got to, as I say,

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start giving ourselves permission.

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'Cause most of us know, like I often
do this exercise where I say to

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people, write down the sentence, I
give myself permission to dot dot dot.

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And I get them to answer to
fill in that question, to

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finish off that sentence, sorry.

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So, because most people do know what it
is they need to do, you know, most people

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know they need to, um, let go of a project
that is causing them too much stress or,

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you know, say no to the in-laws coming
at Christmas or whatever it might be.

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Most people have got a little inkling,
they've just not necessarily had

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that opportunity and that permission
to stop and, and ask that question.

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I mean, I've observed that even when
people have been given permission by

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other people and they've written that
down those sentences, and they, they've

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tried to do it, there seems to be the
shift that needs to go on in inside them.

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And I see this shift happening
when people are really burnt out.

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They're like, right, flipping heck,
I am not going back there, i'm not

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going to back to that level of burnout.

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Um, and then they change their
whole life, they really do.

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They're like, you know this right now.

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Here's my b My boundaries were like,
blah, blah, like this, and Jelly.

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Now they are really, really firm because
I don't want to get where I was before.

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How can we get people to do that
before they get to that absolute

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rock bottom bit of burnout?

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Because it seems to me we're wasting
so much time and energy, 'cause it's

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just that much harder isn't to climb
back up the curve when you are done.

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It's not impossible, but it, it takes
time and it takes, it takes some work, it

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takes a lot of self-awareness and I just
think, gosh, wouldn't it be, wouldn't

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it be good if we could manage to do this
before we have this, this absolute crash?

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But in my experience with myself,
you almost need to have that crash.

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So I don't know that, that, that doesn't
need to be very fair to me that, that

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we need to like experience rock bottom.

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Before we, before we go
up, is there a shortcut?

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Is there any other way?

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Uh, honestly, I'm not
sure there is a shortcut.

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I think in my experience we as humans
often don't learn the lessons we

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need to learn until we learn them.

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And sometimes we do have to hit rock
bottom, as you say, or you know,

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sometimes the pain has to be enough
for us to want to make a change.

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Um, and like you say, I see it all
the time that I, that kind of, I don't

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wanna go back there, it was so bad.

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I now get it.

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I now understand it.

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I think sometimes you can be lucky
and kind of skirt at the edge of it,

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and that's just enough to give you
that little view of, oh my goodness,

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okay, this is only gonna go in
one direction if I'm not careful.

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So I do sometimes see people
kind of come back from the edge

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before they go over the top.

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But now for many of us, we
do have to go over the top.

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I certainly had to when I was, you
know, having my first difficulties

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as a junior doctor, I went to some
very low places before I kind of

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learned how important this stuff is.

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Sometimes I think you
might see it in others.

219
00:11:35,275 --> 00:11:38,815
That can help, um, like someone close
to you if you see them go through it.

220
00:11:39,315 --> 00:11:42,975
But yeah, we all have to, like you say,
have, find that internal motivation.

221
00:11:43,275 --> 00:11:45,965
And I don't know if there is a shortcut.

222
00:11:45,995 --> 00:11:50,225
I think, I think we can absolutely
do some stuff to try to prevent us

223
00:11:50,225 --> 00:11:53,998
getting unwell without having to
get it, if you know what I mean.

224
00:11:54,538 --> 00:11:58,098
So I think we can put in those kind
of healthier boundaries and learn

225
00:11:58,098 --> 00:12:00,018
to say no and do all that stuff.

226
00:12:00,138 --> 00:12:02,288
Um, but you've gotta prioritize it.

227
00:12:02,288 --> 00:12:05,808
And in the busy, busy world we're living
in right now, that's a tough call.

228
00:12:06,075 --> 00:12:08,365
What do you wish you'd given
yourself permission to do?

229
00:12:08,832 --> 00:12:14,702
I would love to have, yeah, got off
the train a little bit earlier than

230
00:12:14,702 --> 00:12:17,452
I did, you know, the stress train.

231
00:12:17,958 --> 00:12:21,998
But again, I'm not, I think it's
really difficult, isn't it, until

232
00:12:21,998 --> 00:12:26,708
you see it for yourself, until you
feel the consequences to really know.

233
00:12:26,708 --> 00:12:30,518
I think we're all a bit young and, and
invulnerable aren't we, to start with.

234
00:12:31,018 --> 00:12:32,758
We don't think it's gonna happen to us.

235
00:12:32,788 --> 00:12:35,428
And we see that particularly in
doctors and high stress professionals

236
00:12:35,428 --> 00:12:37,708
because they've worked all their
lives in an environment where

237
00:12:37,708 --> 00:12:41,008
they do well, they're succeeding,
they're getting a lot of praise.

238
00:12:41,508 --> 00:12:45,318
It's only when they then, something
doesn't go their way that it

239
00:12:45,318 --> 00:12:47,388
can be pretty catastrophic.

240
00:12:47,670 --> 00:12:51,390
it's a bit like the success
trap that my, a good friend and

241
00:12:51,390 --> 00:12:53,220
colleague Nic Malcomson talks about.

242
00:12:53,220 --> 00:12:56,910
He's a, a positive psychologist who
works with practitioner health, works

243
00:12:56,910 --> 00:13:02,040
with doctors, um, and he noticed a,
a really common pattern with high

244
00:13:02,100 --> 00:13:05,490
achieving professionals where, you
know, they've done well most of their

245
00:13:05,520 --> 00:13:10,440
life, they've, um, achieved great
things and life has pretty much gone

246
00:13:10,440 --> 00:13:11,940
in the way that they wanted it to.

247
00:13:11,940 --> 00:13:15,600
But then they find themselves in a job,
for example, where the resources are

248
00:13:15,600 --> 00:13:19,440
too few, the demands are too high, a
situation they're not fully in control

249
00:13:19,440 --> 00:13:22,890
of where they can no longer succeed
and something, you know, bad happens.

250
00:13:22,890 --> 00:13:26,610
So either there's a big complaint or
they just start to not be able to keep

251
00:13:26,610 --> 00:13:30,030
on top of stuff or, you know, they're not
working in the way that they would like

252
00:13:30,030 --> 00:13:36,063
to and, and suddenly that inability to be
successful, um, they, they take it really

253
00:13:36,063 --> 00:13:39,813
personally and they see it as a massive
failure and that has this huge impact

254
00:13:39,813 --> 00:13:44,223
on their sense of self-esteem, sense
of self, um, when actually it wasn't,

255
00:13:44,403 --> 00:13:46,263
it isn't them that's failing, right?

256
00:13:46,533 --> 00:13:49,143
It's just that we are
humans and we have limits.

257
00:13:49,593 --> 00:13:53,463
Um, and in any, any situation,
any of us would break right?

258
00:13:53,463 --> 00:13:56,543
With enough pressure, um,
and without enough resource

259
00:13:56,543 --> 00:13:57,713
to deal with that pressure.

260
00:13:57,903 --> 00:14:03,783
He, he often helps these professionals
to take a step back and just reevaluate

261
00:14:03,783 --> 00:14:09,063
like, what does it mean really to be
successful for them and, and does it

262
00:14:09,153 --> 00:14:10,653
really matter if they make a mistake?

263
00:14:10,653 --> 00:14:13,113
I know you and I talked about this
in our recent Permission to Thrive

264
00:14:13,113 --> 00:14:18,443
gathering about seeing failure as
data, as useful information rather

265
00:14:18,443 --> 00:14:21,713
than something that, you know, is
catastrophic to our sense of self.

266
00:14:22,250 --> 00:14:25,221
Why do we personalize
things so much as doctors?

267
00:14:25,391 --> 00:14:27,731
I don't think it's a doctor
thing, I think it's a human thing.

268
00:14:27,731 --> 00:14:32,831
I think most humans are self aware and
self-reflective and tend to think about

269
00:14:32,831 --> 00:14:34,271
things from the, their point of view.

270
00:14:34,541 --> 00:14:37,451
So people listening to this now will
be listening and thinking, oh yeah,

271
00:14:37,451 --> 00:14:40,331
I recognize that, or I recognize
this, or, yeah, it's natural, right?

272
00:14:40,331 --> 00:14:41,201
We all do it.

273
00:14:41,291 --> 00:14:45,011
Um, we all take in information all
day long and apply it to ourselves.

274
00:14:45,471 --> 00:14:50,515
I think doctors though, do have a very
intense, uh, relationship with their

275
00:14:50,515 --> 00:14:52,825
identity in relation to their work.

276
00:14:53,215 --> 00:14:56,875
So I do think that it is one of
those professions where often you'll

277
00:14:56,875 --> 00:14:59,665
hear doctors saying, it's like, it's
who I am, it's not just what I do.

278
00:15:00,100 --> 00:15:04,420
You know, I am a doctor as opposed
to I, I happen to be a doctor

279
00:15:04,420 --> 00:15:05,770
as, as you know, the work I do.

280
00:15:06,280 --> 00:15:10,090
Um, and I think it's kind of tied up
with a lot of things, but we're often,

281
00:15:10,150 --> 00:15:13,840
um, the type of people that take
responsibility from a very early age,

282
00:15:13,980 --> 00:15:16,080
we're very caring, very compassionate.

283
00:15:16,620 --> 00:15:20,100
Um, we like to be in control
and to be able to do things to

284
00:15:20,100 --> 00:15:21,960
help others and help ourselves.

285
00:15:21,960 --> 00:15:24,750
And I think we're sort of slightly
sold a myth that as a doctor you

286
00:15:24,750 --> 00:15:28,110
can, you can always do that when you
know, we know now that you can't.

287
00:15:28,620 --> 00:15:30,720
And again, that's where it
can cause problems, right?

288
00:15:30,750 --> 00:15:33,720
When you are trying to do a job where
you're trying to help people and then

289
00:15:34,170 --> 00:15:38,270
you suddenly realize, oh, actually
maybe I don't have quite so much power

290
00:15:38,270 --> 00:15:39,800
or control here as I thought I did.

291
00:15:40,050 --> 00:15:43,890
So we sort of see things and take the
system's failings very personally.

292
00:15:43,980 --> 00:15:48,000
Like, I, I failed, you know, or, you
know, you are given more work to do

293
00:15:48,000 --> 00:15:49,530
than you could possibly get done.

294
00:15:49,530 --> 00:15:52,020
But then we blame ourselves
for not being able to do it.

295
00:15:52,020 --> 00:15:55,830
We sort of gaslight ourselves into, in
saying, well, why can't you do that?

296
00:15:55,830 --> 00:15:59,820
You must be absolutely useless because
you can't see 30 patients in three hours.

297
00:16:00,030 --> 00:16:00,690
Who, who'd have thought?

298
00:16:00,720 --> 00:16:01,290
Who'd have thought?

299
00:16:01,290 --> 00:16:02,640
It just, it doesn't work, does it?

300
00:16:03,140 --> 00:16:06,332
Yeah, so there's, there's, I guess, the,
the permission to fail and permission

301
00:16:06,332 --> 00:16:09,602
to see ourselves as human beings,
as, as fallible human beings and the

302
00:16:09,932 --> 00:16:13,652
permission to see the system and its,
its failures as well, and not take

303
00:16:13,652 --> 00:16:15,872
them personally as, as our failures.

304
00:16:15,872 --> 00:16:20,642
I remember in COVID when, or just after
COVID where, you know, access was a real

305
00:16:20,642 --> 00:16:25,772
problem for GPs, even though GPs were like
giving more, um, appointments than ever.

306
00:16:25,772 --> 00:16:29,552
They'd have people being incredibly
vicious down the phone, go, we

307
00:16:29,552 --> 00:16:31,682
can't get appointments, we can't
see, blah, blah, blah, blah, blah.

308
00:16:32,102 --> 00:16:35,012
And people were feeling really hard
done by and, and getting very defensive

309
00:16:35,012 --> 00:16:38,192
and having big arguments rather
than going, yes, isn't it awful?

310
00:16:38,442 --> 00:16:41,712
Yeah, the system's really broken
it's crap that you can't get.

311
00:16:42,323 --> 00:16:45,613
You know, we're really sorry,
but you know, because it wasn't

312
00:16:45,613 --> 00:16:47,683
then, it was totally the system.

313
00:16:48,183 --> 00:16:50,373
And I think we need
permission to be truthful.

314
00:16:50,883 --> 00:16:54,723
You know, I think we sort of role
modeled, um, how to help patients

315
00:16:54,723 --> 00:16:58,983
and how to smooth things over, how
to make people feel more comfortable.

316
00:16:59,283 --> 00:17:01,983
And sometimes actually it's totally
okay and it's really important that

317
00:17:01,983 --> 00:17:07,073
we just tell it how it is, that it is
rubbish, that the system is a bit broken

318
00:17:07,073 --> 00:17:10,463
at the moment or, you know, it's not
okay, and it, and it annoys us too.

319
00:17:11,070 --> 00:17:13,315
And I think that's again, something we
haven't been particularly well, well

320
00:17:13,320 --> 00:17:19,430
modeled, um, in the past, you know,
that kind of sense of having to present.

321
00:17:19,930 --> 00:17:24,490
The health service or what we are
doing, uh, in a really positive light.

322
00:17:24,520 --> 00:17:28,810
And actually, of course we are trying to
help, but we are also in a system that

323
00:17:28,810 --> 00:17:30,550
is really, really struggling right now.

324
00:17:30,790 --> 00:17:31,870
And it's hard for all of us.

325
00:17:31,870 --> 00:17:33,820
So I think it's, yeah, important
that we are honest about that.

326
00:17:34,243 --> 00:17:38,113
I do remember really struggling to
say no to patients that were coming

327
00:17:38,113 --> 00:17:41,203
in requesting, you know, pills
that, that they shouldn't as a very,

328
00:17:41,203 --> 00:17:43,813
very junior, newly qualified GP.

329
00:17:43,813 --> 00:17:48,463
And, uh, some, some guy just come in and
was wanting a load of load of diazepam.

330
00:17:48,463 --> 00:17:50,863
And I went see the, the senior
partner who just said, well, he

331
00:17:50,863 --> 00:17:52,033
knows he doesn't get them from me.

332
00:17:52,093 --> 00:17:52,783
I just say no.

333
00:17:52,873 --> 00:17:55,573
And I was like, can you
just say no to a patient?

334
00:17:55,573 --> 00:17:58,303
Like, straightforward, no, I'm
not doing that without trying

335
00:17:58,303 --> 00:17:59,143
to help them in different ways.

336
00:17:59,143 --> 00:18:00,463
She said, yeah, absolutely.

337
00:18:00,463 --> 00:18:00,733
But

338
00:18:01,239 --> 00:18:04,111
Exactly, he gave you permission,
and then you then able to give

339
00:18:04,111 --> 00:18:05,341
yourself permission to do it.

340
00:18:05,341 --> 00:18:08,551
And I think with the, the kind of
self-care stuff and the mental health

341
00:18:08,551 --> 00:18:11,881
and wellbeing stuff, that's what we're
starting to see is that as more and more

342
00:18:11,881 --> 00:18:17,161
of us are openly looking after ourselves
and giving ourselves permission to, you

343
00:18:17,161 --> 00:18:21,781
know, go home on time or take breaks or
say no to things or go less than full time

344
00:18:21,781 --> 00:18:25,891
or whatever it is we need to be doing,
that other doctors are then seeing that

345
00:18:25,951 --> 00:18:30,991
and are get, getting permission from us to
give themselves permission to do that too.

346
00:18:31,331 --> 00:18:34,991
Although I have seen that there is
a little bit of a generational issue

347
00:18:34,991 --> 00:18:39,161
here as well, because you've got
people in, in my generation, I've

348
00:18:39,161 --> 00:18:40,816
just turned, I'm, I've just turned 50.

349
00:18:40,996 --> 00:18:45,846
I'm Gen X, And then there's people
coming up who didn't do those really,

350
00:18:45,846 --> 00:18:48,876
really, really long shifts that we
used to do, like 120 hour weeks.

351
00:18:49,236 --> 00:18:50,436
But I had a team around me.

352
00:18:50,436 --> 00:18:51,276
We had a doctor's mess.

353
00:18:51,276 --> 00:18:51,996
It was great fun.

354
00:18:51,996 --> 00:18:53,316
It was there some camaraderie.

355
00:18:53,826 --> 00:18:57,346
Um, we have people that have been
treated like shift workers and, and

356
00:18:57,346 --> 00:18:59,676
then quite rightly they're saying,
well, then my shift finishes.

357
00:18:59,676 --> 00:19:01,716
I go home and, and I
demand my rights and stuff.

358
00:19:01,716 --> 00:19:05,316
And then you've got, other people have
gone the other way of saying, well,

359
00:19:05,316 --> 00:19:08,576
nope, you know, and probably just
putting quite appropriate boundaries.

360
00:19:08,576 --> 00:19:12,386
But people in my generation who are
now the leaders and the, the senior

361
00:19:12,386 --> 00:19:16,426
clinicians, they're like, well, okay,
yeah, of course we have to listen to you.

362
00:19:16,456 --> 00:19:17,326
That's quite right.

363
00:19:17,326 --> 00:19:19,036
But that then means that I have to do it.

364
00:19:19,516 --> 00:19:23,581
So your wellbeing, the fact that you are
having your wellbeing stuff and going

365
00:19:23,581 --> 00:19:27,841
off sick at the drop of the hat and, and,
and is meaning that I have to work extra.

366
00:19:28,171 --> 00:19:29,731
So how do we solve that conundrum?

367
00:19:29,731 --> 00:19:32,287
Because I think it's a
real generational issue.

368
00:19:32,411 --> 00:19:33,991
Yeah, I, I absolutely agree.

369
00:19:34,137 --> 00:19:39,957
Um, and I also see a lot of senior
colleagues who are starting to put

370
00:19:39,957 --> 00:19:44,727
wellbeing at the forefront for their
juniors, but not for themselves.

371
00:19:45,073 --> 00:19:48,043
So I've, I've, you know, I've heard
more than once from a senior colleague,

372
00:19:48,043 --> 00:19:51,433
you know, I'm absolutely fine, I
encourage my, uh, you know, my juniors

373
00:19:51,433 --> 00:19:54,583
to go off sick and I say, okay, and,
and do you let yourself go off sick?

374
00:19:54,583 --> 00:19:55,738
And then, oh, no, no, no.

375
00:19:55,988 --> 00:19:58,268
So I think it, it absolutely is.

376
00:19:58,298 --> 00:20:00,278
Um, there are generational differences.

377
00:20:00,414 --> 00:20:05,364
And I think this is, if you look
at any kind of change throughout

378
00:20:05,364 --> 00:20:07,404
human history, it can take time.

379
00:20:07,674 --> 00:20:10,614
It can take several generations
for a big shift to occur.

380
00:20:11,160 --> 00:20:14,600
And it's always difficult in the
transition, because you're always

381
00:20:14,600 --> 00:20:18,140
gonna have people that are on the,
the kind of the previous way of

382
00:20:18,140 --> 00:20:22,460
thinking if you like, uh, against,
clashing with the new way of thinking.

383
00:20:22,983 --> 00:20:27,720
I always think about the individual doctor
in front of me and I think whoever they

384
00:20:27,720 --> 00:20:31,350
are, whether they are a junior doctor
in their first year on the wards, or

385
00:20:31,350 --> 00:20:35,160
whether they are a senior, you know,
GP or hospital consultant that's been

386
00:20:35,160 --> 00:20:40,310
doing this for 20 years, they have this
absolutely the same human rights, the

387
00:20:40,310 --> 00:20:47,180
same right to for their work, not to
damage their health, for them to be

388
00:20:47,180 --> 00:20:52,750
able to do work that is rewarding and
enjoyable and that doesn't make them ill.

389
00:20:53,250 --> 00:20:56,310
So I was trying to try to bring
it back to that individual.

390
00:20:56,760 --> 00:21:01,020
You know, if they're struggling because
their juniors are looking after themselves

391
00:21:01,050 --> 00:21:03,840
much better and they're then feeling
they've got too much work on, then we

392
00:21:03,840 --> 00:21:05,130
need to look at how much work they've got.

393
00:21:05,630 --> 00:21:07,160
You know, we have to
bring it back to them.

394
00:21:07,430 --> 00:21:10,220
What are their choices and
options in that situation?

395
00:21:10,720 --> 00:21:13,660
Um, because I do think we
generally, as doctors and as really

396
00:21:13,810 --> 00:21:19,230
compassionate, hardworking people
will just flog ourselves, right?

397
00:21:19,230 --> 00:21:22,260
We will just keep going and going and
going, like you said, if they see, see

398
00:21:22,260 --> 00:21:26,910
10 patients, you see 10 patients see 20,
you see 20, see 30, you try and see 30.

399
00:21:26,910 --> 00:21:28,470
And we just keep going.

400
00:21:28,830 --> 00:21:31,590
And I think we have to take personal
responsibility as individuals to say,

401
00:21:31,590 --> 00:21:36,770
hang on a minute, this is too much, you
know, for me, this isn't healthy and safe.

402
00:21:36,770 --> 00:21:41,750
So I think it's actually the onus is on
those, the, that older generation, if

403
00:21:41,750 --> 00:21:45,690
you will, to, for them to be brave and
come forward and say, hang on, I'm not,

404
00:21:46,020 --> 00:21:47,700
I'm not coping here, this is too much.

405
00:21:48,210 --> 00:21:49,380
And we will help them.

406
00:21:49,890 --> 00:21:50,700
Because you are right.

407
00:21:50,700 --> 00:21:55,460
The system isn't working, so it
shouldn't be that one particular group

408
00:21:55,460 --> 00:21:56,690
should take the pressure of that.

409
00:21:57,226 --> 00:21:57,616
Yeah.

410
00:21:57,616 --> 00:21:58,666
I hundred percent agree.

411
00:21:58,666 --> 00:22:01,366
You know, rather than saying to the
younger generation, oh, you know,

412
00:22:01,366 --> 00:22:04,246
stop demanding wellbeing, stop
demanding that you're thriving at work.

413
00:22:04,246 --> 00:22:05,386
But that's ridiculous, isn't it?

414
00:22:05,386 --> 00:22:07,096
Let's start saying the older generation.

415
00:22:07,486 --> 00:22:08,836
You have the same rights.

416
00:22:08,836 --> 00:22:14,086
You, I love that the equal rights for
your work not to be damaging your health,

417
00:22:14,386 --> 00:22:17,626
and just because you might be a clinical
lead or senior consultant senior partner

418
00:22:17,626 --> 00:22:22,716
that does not, that does not mean you've
got less right to take a day off than

419
00:22:22,716 --> 00:22:24,486
the most junior person in your team.

420
00:22:24,486 --> 00:22:25,986
Then that's just ridiculous.

421
00:22:25,986 --> 00:22:29,466
In fact, you probably need to do it
more because you've got so much more

422
00:22:29,466 --> 00:22:32,316
stuff going on and more critical
stuff that you need to do probably.

423
00:22:32,466 --> 00:22:33,096
Absolutely.

424
00:22:33,096 --> 00:22:35,391
And you've got that responsibility
to role model as well.

425
00:22:35,646 --> 00:22:39,936
I, I always think about the, was it the,
um, Danish Prime Minister, or it was one

426
00:22:39,936 --> 00:22:43,266
of the Scandinavian countries where the
Prime Minister took some sick leave for

427
00:22:43,266 --> 00:22:44,736
mental health reasons a few years ago.

428
00:22:44,736 --> 00:22:47,466
And I think that is such a great example.

429
00:22:47,466 --> 00:22:50,076
Like there's nobody that
this doesn't apply to.

430
00:22:50,576 --> 00:22:52,766
There's nobody, it is not just
'cause you, you know, further up

431
00:22:52,766 --> 00:22:55,356
the tree you go the less, it's okay.

432
00:22:55,416 --> 00:22:58,206
I do think there is truth
that it's can feel harder.

433
00:22:58,656 --> 00:23:01,686
It can feel harder because of the
stories that we tell ourselves that

434
00:23:01,806 --> 00:23:04,446
you know, oh, I can't do this 'cause
I'm the one in control, or I'm the

435
00:23:04,446 --> 00:23:08,496
one in charge, or, you know, I, what
impact will that have on everyone else?

436
00:23:08,496 --> 00:23:11,796
But, um, you know, during COVID,
Boris Johnson got COVID right?

437
00:23:11,796 --> 00:23:13,106
He's still allowed to go into a hospital.

438
00:23:13,466 --> 00:23:15,246
There's nobody, these things don't affect.

439
00:23:15,246 --> 00:23:19,456
So I think it's really important that
everybody at every stage of their

440
00:23:19,456 --> 00:23:23,256
career gets the same message and
the same permission to look after

441
00:23:23,436 --> 00:23:23,766
yeah.

442
00:23:23,766 --> 00:23:27,156
And just a caveat there, I'm not
saying that all, all people in the, the

443
00:23:27,156 --> 00:23:30,741
generations below me are over egging
it on the wellbeing front, not at all.

444
00:23:30,741 --> 00:23:32,511
But you know, they're
really, really diligent.

445
00:23:32,511 --> 00:23:35,751
And I think sometimes when people
feel that they're not listened to,

446
00:23:36,081 --> 00:23:39,081
that they're, it, they're not taken
seriously, they can get a little bit

447
00:23:39,081 --> 00:23:41,961
more militant in order to say, well,
okay, if you're not just gonna do it,

448
00:23:41,961 --> 00:23:44,841
we're gonna, we are gonna demand it,
'cause it seems to be the only way

449
00:23:44,841 --> 00:23:46,371
we can, we, we can actually get it.

450
00:23:46,371 --> 00:23:50,151
But then it just puts people against
each other and, and then people say,

451
00:23:50,151 --> 00:23:51,531
well, I don't wanna appear like that.

452
00:23:51,531 --> 00:23:53,331
And they're like, well, I
don't wanna appear like that.

453
00:23:53,331 --> 00:23:55,431
And it's, it, it, it's
just madness, isn't it?

454
00:23:55,431 --> 00:23:58,551
And actually, the thing that's
failing is, is the system.

455
00:23:58,581 --> 00:24:03,161
And sometimes the system needs
to be allowed to fail for

456
00:24:03,161 --> 00:24:06,401
someone actually higher up to
have to try and fix the problem.

457
00:24:06,491 --> 00:24:10,921
I think if you are always the one that's
plugging the rotor gap, well maybe how,

458
00:24:10,921 --> 00:24:14,861
how about you don't plug that rotor gap
and, oh dear, what's gonna happen now?

459
00:24:14,861 --> 00:24:18,574
Well now someone's gonna
take, note of that, right?

460
00:24:18,604 --> 00:24:22,624
I mean, that's really hard to say because
genuinely it affects patients, doesn't it?

461
00:24:22,624 --> 00:24:24,604
So, so how do we, how do we square that?

462
00:24:24,994 --> 00:24:25,324
Caroline?

463
00:24:25,324 --> 00:24:28,144
Because one of the reasons
people give is that they don't

464
00:24:28,144 --> 00:24:29,494
want patients to come to harm.

465
00:24:29,884 --> 00:24:31,684
And that's always the excuse, isn't it?

466
00:24:31,744 --> 00:24:32,704
You know, harm to patients.

467
00:24:32,704 --> 00:24:35,819
Harm to patients, and of course,
we don't want patients to come to

468
00:24:35,819 --> 00:24:37,630
come to harm, so what do we do?

469
00:24:37,954 --> 00:24:41,601
So if, I mean, if you follow
that through, then, what's the

470
00:24:41,601 --> 00:24:43,041
most harmful thing for a patient?

471
00:24:43,041 --> 00:24:45,831
An unwell doctor or an
unwell nurse, right?

472
00:24:45,861 --> 00:24:51,651
So do I really want me or my family to be
seen by someone who is, you know, looks

473
00:24:51,651 --> 00:24:55,341
okay and seems okay, but when they're
at home at night, they're suicidal

474
00:24:55,341 --> 00:25:00,381
and, you know, drinking too much and
deeply depressed and, you know, no.

475
00:25:00,771 --> 00:25:04,811
Um, actually I think the, um, if
you really want to do the best for

476
00:25:04,811 --> 00:25:10,661
your patients, then you absolutely
have to be in reasonable health.

477
00:25:11,280 --> 00:25:14,370
Um, you know, we can all work with a
little bit of a cold or a little bit

478
00:25:14,370 --> 00:25:18,180
of lone mood or a little bit, but you
know, that we know from the evidence,

479
00:25:18,180 --> 00:25:24,000
there's so much evidence that, you
know, unwell, unrested, um, unhealthy

480
00:25:24,450 --> 00:25:28,080
clinicians make more mistakes and
ultimately harm their patients more.

481
00:25:28,460 --> 00:25:31,130
So it's about patient harm
and not doing patient's harm.

482
00:25:31,130 --> 00:25:33,320
You're better off being off than being in.

483
00:25:33,620 --> 00:25:37,225
And that you've gotta take the longer
term view as well, because yes, it might

484
00:25:37,225 --> 00:25:40,370
mean that a few patients have their
appointment canceled or their surgery

485
00:25:40,370 --> 00:25:42,500
canceled, for example, or postponed.

486
00:25:42,500 --> 00:25:47,050
But in the long run, you, you've
potentially got 10, 20, 30, 40 years ahead

487
00:25:47,050 --> 00:25:50,650
of you to give to, you know, the health
service and to give to your patients.

488
00:25:50,650 --> 00:25:54,870
So, um, when we're talking about taking
a week off or a month off, or even six

489
00:25:54,870 --> 00:25:59,220
months off, if you take the long view,
that is gonna be absolutely the best

490
00:25:59,220 --> 00:26:02,850
thing for you in order to then be able
to help your patients longer term.

491
00:26:03,350 --> 00:26:08,090
I think we have to also gently challenge
that kind of slightly, um, omnipotent

492
00:26:08,090 --> 00:26:12,440
sort of sense of like, you know,
everything will collapse without me.

493
00:26:12,860 --> 00:26:15,350
It, it really doesn't tend to.

494
00:26:15,350 --> 00:26:18,950
And I say that even when you are
the lead of your service or you are

495
00:26:18,950 --> 00:26:23,060
your single-handed GP, you know,
there are mechanisms in place.

496
00:26:23,060 --> 00:26:26,920
It might not be the absolute ideal,
but there are mechanisms in place.

497
00:26:26,920 --> 00:26:30,280
And any one of us could get run
over by a bus tomorrow, right?

498
00:26:30,280 --> 00:26:34,180
And the world would continue, you
know, people would still get seen.

499
00:26:34,180 --> 00:26:38,156
So I think we have to gently start
to challenge that idea that, it's

500
00:26:38,156 --> 00:26:40,646
gonna, like the sky is gonna fall
down if we take some time off.

501
00:26:40,646 --> 00:26:41,576
It really isn't.

502
00:26:41,831 --> 00:26:44,846
And I, and I say that having been
there, you know, having felt that,

503
00:26:44,906 --> 00:26:46,646
that, you know, my life was over.

504
00:26:46,646 --> 00:26:47,876
I couldn't be a doctor again.

505
00:26:47,876 --> 00:26:50,036
I could, you know, you
know, all those catastrophic

506
00:26:50,036 --> 00:26:52,126
thoughts went through my head.

507
00:26:52,626 --> 00:26:56,676
But, you know, a few days, a few
weeks into some time off, I realized,

508
00:26:56,713 --> 00:27:00,114
okay, yeah, i'm not as indispensable
as perhaps I thought I was.

509
00:27:00,204 --> 00:27:00,504
Yeah.

510
00:27:00,834 --> 00:27:03,774
So, no, and that doesn't mean
I'm not great at my job and

511
00:27:03,774 --> 00:27:05,844
can help a lot of people right.

512
00:27:05,844 --> 00:27:07,404
In my work and in my lifetime.

513
00:27:07,734 --> 00:27:09,804
But I'm gonna do that if I'm well.

514
00:27:10,054 --> 00:27:12,241
We often think we're
indispensable to our work.

515
00:27:12,421 --> 00:27:13,021
We are not.

516
00:27:13,201 --> 00:27:17,071
And then we think we are dispensable
to our families and we are not.

517
00:27:17,401 --> 00:27:20,311
We are indispensable to our families
and those are the people that end

518
00:27:20,311 --> 00:27:23,671
up being the residual beneficiary of
everything else when we're sacrifice

519
00:27:23,671 --> 00:27:25,561
everything to our job, aren't they?

520
00:27:26,405 --> 00:27:28,835
Caroline, in terms of permission,
there's obviously permission to give

521
00:27:28,835 --> 00:27:33,095
yourself time off, to take a break,
to rest, to rejuvenate, um, you

522
00:27:33,095 --> 00:27:35,045
know, to to practice necessary care.

523
00:27:35,817 --> 00:27:39,715
What else do doctors and other high stress
professionals find it really difficult

524
00:27:39,715 --> 00:27:41,425
to give themselves permission to do?

525
00:27:41,425 --> 00:27:43,675
Are there any hidden permissions
that we need to know about?

526
00:27:43,913 --> 00:27:45,323
Oh, definitely loads.

527
00:27:46,073 --> 00:27:49,973
Um, I think one of the ones I see most
often is, uh, permission to be you,

528
00:27:50,153 --> 00:27:51,353
permission to be who you really are.

529
00:27:51,533 --> 00:27:53,858
Like so to show up in your work as.

530
00:27:54,358 --> 00:27:55,468
Your authentic self.

531
00:27:55,708 --> 00:28:02,476
So I see a lot of doctors who are, uh,
very funny or very creative or you know,

532
00:28:02,476 --> 00:28:06,526
they've got kind of hidden interests
or ways of being in the world that they

533
00:28:06,526 --> 00:28:10,306
just don't bring to their work, 'cause
they feel as if there's this kind of tick

534
00:28:10,306 --> 00:28:14,116
box of what it means to be a doctor and
what they should and shouldn't be like.

535
00:28:14,446 --> 00:28:16,456
And that can express itself
in all sorts of ways.

536
00:28:16,456 --> 00:28:20,626
So it might be from like the kind of
socks you wear, up to the types of

537
00:28:20,626 --> 00:28:24,706
projects you take on, or you know,
what you choose to do for your work.

538
00:28:24,736 --> 00:28:27,856
You know, you might choose to
go, um, part-time so that you can

539
00:28:27,856 --> 00:28:31,006
explore doing something completely
different in the rest of your week.

540
00:28:31,516 --> 00:28:34,216
So that can take many, many forms,
but I see that really commonly in

541
00:28:34,216 --> 00:28:38,846
doctors, this kind of hiding of their
true self and their true passions

542
00:28:38,846 --> 00:28:41,066
and what really brings them alive.

543
00:28:41,366 --> 00:28:43,916
And when they can start to give themselves
permission to bring that into their

544
00:28:43,916 --> 00:28:46,556
work, it's so joyful, it's so wonderful.

545
00:28:46,826 --> 00:28:51,026
It's like, oh, oh, I didn't realize, you
know, that I could have a bit more fun

546
00:28:51,356 --> 00:28:57,116
with my work or, um, that I could steal
my job in a way that means I do more of

547
00:28:57,116 --> 00:28:59,186
the stuff I love and less of the stuff I

548
00:28:59,322 --> 00:29:02,172
Yeah, we have this weird guilt
thing that we've got to do.

549
00:29:02,262 --> 00:29:05,082
Everything that's demanded in our role.

550
00:29:05,082 --> 00:29:10,092
I remember a career session I was running
for a bunch of GPs and one, we would talk

551
00:29:10,092 --> 00:29:11,352
about how to work in a center genius.

552
00:29:11,352 --> 00:29:14,202
And one GP said about how they
absolutely loved being on call,

553
00:29:14,322 --> 00:29:15,762
triaging on call, loved it.

554
00:29:16,182 --> 00:29:20,622
Another GP said how they absolutely loved
admin, give them admin all day every day.

555
00:29:20,622 --> 00:29:23,822
And they looked at each other and
went, we should work together.

556
00:29:23,882 --> 00:29:26,132
Like, yeah, you two genuinely should work.

557
00:29:26,342 --> 00:29:28,592
But I've never heard of a GP just
being able to sit there and do

558
00:29:28,592 --> 00:29:30,782
admin and a GP just doing on call.

559
00:29:30,782 --> 00:29:33,392
Now I know there are some progressive
practices are doing more of that,

560
00:29:33,392 --> 00:29:36,332
but you know, there is, there are
some, pat, there's some, you know,

561
00:29:36,332 --> 00:29:39,212
GPs, i'm talking about GPs 'cause
I'm a GP so I, you know that.

562
00:29:39,212 --> 00:29:42,332
But yeah, love getting really
into, you know, diabetes,

563
00:29:42,332 --> 00:29:43,382
chronic disease management.

564
00:29:43,882 --> 00:29:47,297
I could do that, you know, but I
really, I quite like the emergency

565
00:29:47,297 --> 00:29:48,527
stuff or whatever and, um.

566
00:29:48,922 --> 00:29:51,682
But we think, well, 'cause I'm a
generalist, I must do everything.

567
00:29:51,742 --> 00:29:54,982
I must do everything that's required by my
specialty because that's what doctor does,

568
00:29:54,982 --> 00:29:59,242
and if I ask someone else to do this, bits
I don't like, I am dumping on them, which

569
00:29:59,242 --> 00:30:03,982
is just nonsensical and  doesn't really
happen in that many other professions.

570
00:30:03,982 --> 00:30:06,442
Or maybe it does, if you're listening
and you are in different profession and

571
00:30:06,442 --> 00:30:08,272
you are, you've got examples of that.

572
00:30:08,272 --> 00:30:11,482
I'd love to hear it, but I'm
presuming you've experienced a lot

573
00:30:11,482 --> 00:30:13,702
of that with, with your patients
coming in saying, well, I can't

574
00:30:13,702 --> 00:30:15,682
possibly drop that bit or that bit.

575
00:30:15,932 --> 00:30:16,412
Absolutely.

576
00:30:16,412 --> 00:30:17,732
And I don't think it's just generalists.

577
00:30:17,732 --> 00:30:21,122
I think it applies to all doctors, and
it's been particularly bad over the

578
00:30:21,122 --> 00:30:26,522
last 30 to 40 years, because there was
a big shift in how we regulated our

579
00:30:26,522 --> 00:30:31,052
profession and how we, uh, monitor all
the different things that doctors do.

580
00:30:31,532 --> 00:30:35,072
Um, and again, after in the aftermath of
things like the Harold Shipman case, et

581
00:30:35,072 --> 00:30:39,632
cetera, when appraisal changed, and so we
went from being a profession that really

582
00:30:39,632 --> 00:30:42,002
did cater for a lot of different tastes.

583
00:30:42,302 --> 00:30:45,002
You know, when I first went into
medical school, doctors then could

584
00:30:45,002 --> 00:30:49,382
still very much pick and choose the
jobs they did, the style of working they

585
00:30:49,402 --> 00:30:50,932
did, the things they did day to day.

586
00:30:51,112 --> 00:30:54,202
So one might do more research, one
might do more teaching, another

587
00:30:54,202 --> 00:30:55,792
might do more clinical and so on.

588
00:30:56,152 --> 00:30:59,512
Whereas now we are very much living
in an age where it's everybody

589
00:30:59,512 --> 00:31:00,612
has to do a bit of everything.

590
00:31:00,892 --> 00:31:03,297
You know, I'm coming up to my
annual appraisal again, and

591
00:31:03,297 --> 00:31:04,857
I'm expected to tick every box.

592
00:31:04,857 --> 00:31:07,407
I'm expected to have done a bit of
research and a bit of this and a

593
00:31:07,407 --> 00:31:10,887
bit of that, and, and actually it
doesn't suit us all, it absolutely

594
00:31:10,887 --> 00:31:11,847
doesn't, and you're quite right.

595
00:31:11,847 --> 00:31:15,447
There is some really progressive
workplaces which are recognizing this

596
00:31:15,447 --> 00:31:16,977
and fighting back against that a bit.

597
00:31:17,367 --> 00:31:21,557
So a lovely example of some, um,
supervision, you know, in some,

598
00:31:21,617 --> 00:31:25,907
specialties where supervision is really a
wonderful embedded part of the practice,

599
00:31:25,907 --> 00:31:27,437
like in psychiatry, for example.

600
00:31:27,887 --> 00:31:32,087
Um, there for a long time every
doctor had to supervise, but

601
00:31:32,087 --> 00:31:33,887
it didn't suit every doctor.

602
00:31:33,947 --> 00:31:36,647
You know, some people were really
good at it, really nurturing and

603
00:31:36,647 --> 00:31:37,997
wonderful and loved doing it.

604
00:31:38,057 --> 00:31:40,072
Others really didn't like it.

605
00:31:40,132 --> 00:31:42,592
Lots of problems for their supervisees.

606
00:31:42,922 --> 00:31:46,072
Whereas some trust in our recognizing
that and saying, it's okay, we'll

607
00:31:46,072 --> 00:31:48,862
let you know the people that wanna do
it can do it and take on a few more.

608
00:31:49,042 --> 00:31:51,172
The people who don't wanna do
it, you know, don't have to.

609
00:31:51,172 --> 00:31:55,822
So again, it's about permission and I
think not just individual permission

610
00:31:55,882 --> 00:32:00,382
as a profession, saying to ourselves
that actually it's okay that in our

611
00:32:00,382 --> 00:32:07,102
GP practice or in our department or
across our trust or local area, we

612
00:32:07,102 --> 00:32:09,652
are going to give ourselves permission
to do this a bit differently.

613
00:32:10,152 --> 00:32:11,202
You know, like in COVID.

614
00:32:11,442 --> 00:32:14,502
When COVID came along,
suddenly all bets were off.

615
00:32:14,622 --> 00:32:18,522
You know, people were given this
freedom, weren't they, to, to pull their

616
00:32:18,522 --> 00:32:20,742
resources and do the best they could.

617
00:32:21,192 --> 00:32:24,252
And it got rid of a lot of that red
tape and it gave people permission

618
00:32:24,522 --> 00:32:27,522
to be autonomous and say, okay,
we can do this and we can do it

619
00:32:27,522 --> 00:32:28,722
quickly, and we can do it well.

620
00:32:29,202 --> 00:32:31,482
And that's, I think, what we've
lost sight of a little bit in

621
00:32:31,482 --> 00:32:33,162
modern medicine as it is today.

622
00:32:33,412 --> 00:32:37,167
So again, we've gotta reclaim that
permission to say no, we don't

623
00:32:37,167 --> 00:32:38,517
necessarily have to do it this

624
00:32:38,518 --> 00:32:41,308
Yes, and it's, it's that permission
to play to your strengths rather than

625
00:32:41,308 --> 00:32:42,628
try and develop all your weaknesses.

626
00:32:42,628 --> 00:32:45,229
And that's just like
good, good psychology.

627
00:32:45,254 --> 00:32:48,079
I, I remember my coaching course
being taught about, well, you know,

628
00:32:48,079 --> 00:32:50,869
the strength surveys and stuff, and
that you get much more bang for your

629
00:32:50,869 --> 00:32:54,489
buck if you develop your strengths
then if you develop your weaknesses.

630
00:32:54,489 --> 00:32:57,669
You know, I'm not very good at accounts
and stuff like that, and I spent hours on

631
00:32:57,669 --> 00:33:00,999
spreadsheets if I wanted to, but actually
I'd be much better getting better at

632
00:33:00,999 --> 00:33:04,569
doing podcasts, you know, because that's
my strength and that's what I like doing.

633
00:33:05,168 --> 00:33:08,955
But we, we feel guilty about
the stuff we are not so good at

634
00:33:08,955 --> 00:33:10,515
and think we ought to be doing.

635
00:33:10,515 --> 00:33:11,775
It's that ought word, isn't it?

636
00:33:11,835 --> 00:33:12,315
Isn't it?

637
00:33:12,642 --> 00:33:15,457
Mm. And in my book, I talk
about permission to feel guilt.

638
00:33:16,049 --> 00:33:19,109
And I know we've spoken about
this before, but you know, I

639
00:33:19,109 --> 00:33:20,369
would say that's a good guilt.

640
00:33:20,869 --> 00:33:23,779
It's a good guilt that we
feel because we want to do.

641
00:33:24,279 --> 00:33:25,209
Everything we're meant to do.

642
00:33:25,209 --> 00:33:30,572
We want to kind of be good doctors and
good, you know, parents and children and

643
00:33:30,572 --> 00:33:33,242
friends and, but we, we just can't, right?

644
00:33:33,242 --> 00:33:37,262
It is just, there are some limits to
our human capabilities and capacities.

645
00:33:37,395 --> 00:33:40,159
So I think that, that
it's okay to feel guilty.

646
00:33:40,489 --> 00:33:43,399
But like you said, guilt does tend to
make us look at what we're not doing

647
00:33:43,459 --> 00:33:44,599
and not look at what we are doing.

648
00:33:45,099 --> 00:33:48,489
So that's something you are identifying
in listening to this, you know, you think,

649
00:33:48,789 --> 00:33:52,779
well, okay, I'm probably feeling this girl
'cause I'm, I'm not a psychopath, right?

650
00:33:53,079 --> 00:33:54,189
I'm a good person.

651
00:33:54,529 --> 00:33:56,449
and what is it I am doing to help?

652
00:33:56,449 --> 00:33:56,899
Well, hang on.

653
00:33:56,899 --> 00:34:00,469
I've seen this number of patients today,
or I've helped to lead this service

654
00:34:00,469 --> 00:34:03,769
through this transition recently, or
whatever it is you might have been doing.

655
00:34:03,769 --> 00:34:06,739
I promise you, you start to look
at what you are doing, you'll

656
00:34:06,739 --> 00:34:08,859
see a lot of evidence for it.

657
00:34:08,949 --> 00:34:12,656
'Cause as caring, compassionate,
hardworking doctors and, and

658
00:34:12,656 --> 00:34:15,896
high stress professionals,
generally we are doing a lot.

659
00:34:16,400 --> 00:34:20,120
And there's also that for, you know,
those of you out there with families

660
00:34:20,360 --> 00:34:23,300
permission to give your kids baked
beans for dinner, they will be full.

661
00:34:23,300 --> 00:34:24,110
They'll love it.

662
00:34:24,170 --> 00:34:26,840
Beans and cheese and jack,
potatoes and sausages, you

663
00:34:26,840 --> 00:34:28,100
know, all that sort of stuff.

664
00:34:28,100 --> 00:34:30,740
You don't need to have a perfectly
cooked organic meal all the

665
00:34:30,740 --> 00:34:33,970
time, but we just sort of more
and more pressure on ourselves.

666
00:34:34,220 --> 00:34:35,244
Permission to make it easy.

667
00:34:35,765 --> 00:34:37,235
That's one of my favorite ones.

668
00:34:37,235 --> 00:34:41,195
I mean, this, the book I wrote, the, um,
Permission: How to Feel, Heal and Thrive

669
00:34:41,195 --> 00:34:45,095
in a Challenging World, um, you know,
I've talked a lot about emotions in that.

670
00:34:45,095 --> 00:34:48,515
So I've talked about, you know,
permission to feel anxious, permission

671
00:34:48,515 --> 00:34:52,085
to grieve, permission to feel angry,
permission to feel happy or joyful,

672
00:34:52,085 --> 00:34:56,465
or, but the, it was the first of a
sort of three part book in my head.

673
00:34:56,465 --> 00:34:59,495
And the second part's very much
those like, you know, permission

674
00:34:59,495 --> 00:35:03,362
to say no, permission to let go of
stuff, permission not to be perfect,

675
00:35:03,392 --> 00:35:05,042
permission to make things easy.

676
00:35:05,492 --> 00:35:10,712
And I think in the modern world, we live
in these little, um, powerful questions,

677
00:35:10,712 --> 00:35:12,182
like what would make this easier?

678
00:35:12,682 --> 00:35:14,332
Are so helpful.

679
00:35:14,722 --> 00:35:17,872
'cause we are so often thinking
it's gonna be hard, right?

680
00:35:18,352 --> 00:35:21,742
Like, oh, I wanna make a change
to my, my diet or my daily

681
00:35:21,742 --> 00:35:23,362
routine or something like that.

682
00:35:23,362 --> 00:35:27,022
And immediately we're full of all the
complexity of it and the challenge of it

683
00:35:27,022 --> 00:35:30,322
and all the noise of all the information
and choices that are out there.

684
00:35:30,352 --> 00:35:34,672
And actually we can just stop, take a
breath and say, what would make this easy?

685
00:35:35,032 --> 00:35:37,342
Give us permission to make it easier.

686
00:35:37,786 --> 00:35:39,406
We overcomplicate things, don't we?

687
00:35:39,406 --> 00:35:42,256
I think we have been brought up to
think if it's hard, it must be worthy

688
00:35:42,496 --> 00:35:43,936
and it must be the right thing to do.

689
00:35:44,194 --> 00:35:47,044
I think the hardest bit is the permission
bit though, Rachel, honestly, because

690
00:35:47,044 --> 00:35:50,224
we're not role modeled it and because
we don't think it's okay to do that.

691
00:35:50,224 --> 00:35:50,404
Right.

692
00:35:50,404 --> 00:35:54,394
We think that it all has to be really
hard work and we've got to tick all the

693
00:35:54,394 --> 00:35:59,224
boxes and we don't stop and think to ask,
actually, could I make this bit easier?

694
00:36:00,027 --> 00:36:05,201
So all this permission, and I
wholeheartedly agree with everything

695
00:36:05,201 --> 00:36:08,346
you've said, but there's a bit
of me going, yeah, but how?

696
00:36:08,596 --> 00:36:12,191
Because my head might agree with it,
Caroline, but then the next time it

697
00:36:12,191 --> 00:36:16,861
comes to maybe saying no or meaning that
someone else is inconvenience, not me.

698
00:36:16,921 --> 00:36:19,935
'cause I need to look after myself,
there's gonna be me gonna go,

699
00:36:19,935 --> 00:36:21,615
oh, but Rachel, I mean, really?

700
00:36:21,615 --> 00:36:21,945
Yes.

701
00:36:21,945 --> 00:36:24,645
I mean, I know you talk about
this, but in in this case it

702
00:36:24,645 --> 00:36:25,915
probably doesn't apply here.

703
00:36:26,295 --> 00:36:27,435
How do we go about doing that?

704
00:36:27,520 --> 00:36:29,745
What, what helps and what doesn't help?

705
00:36:30,245 --> 00:36:33,330
I'm glad you've asked that because
it isn't a theoretical thing.

706
00:36:33,330 --> 00:36:35,640
This is a very practical thing.

707
00:36:36,140 --> 00:36:36,320
Right.

708
00:36:36,320 --> 00:36:37,550
We actually have to do it.

709
00:36:37,910 --> 00:36:40,820
To give yourself permission to leave on
time, you actually have to leave on time.

710
00:36:41,370 --> 00:36:43,290
You know, to give yourself
permission to take a break, you

711
00:36:43,290 --> 00:36:45,060
actually have to take a break.

712
00:36:45,420 --> 00:36:47,700
So it is a practical doing thing, right?

713
00:36:47,700 --> 00:36:51,180
Otherwise it's just, it's just theory
and we're just reading a book, right?

714
00:36:51,240 --> 00:36:53,940
And it's just not real life and
we're not applying it, and yeah.

715
00:36:54,240 --> 00:36:56,970
So I would say start small and start easy.

716
00:36:57,450 --> 00:37:01,440
So, you know, you might not, you might be
staying four hours late every day at work.

717
00:37:01,470 --> 00:37:05,790
You are not maybe suddenly gonna leave
on time the next day, but could you

718
00:37:05,790 --> 00:37:07,650
leave maybe half an hour earlier?

719
00:37:08,310 --> 00:37:11,550
Maybe you don't start saying no
to everything, but is there a

720
00:37:11,550 --> 00:37:14,580
little something that you would
find it slightly easier to say

721
00:37:14,580 --> 00:37:15,960
no to that you could start with?

722
00:37:16,460 --> 00:37:20,904
So start small, make it easier,
and build that confidence because

723
00:37:21,024 --> 00:37:23,214
this is a practice, it's a
thing you have to keep doing.

724
00:37:23,714 --> 00:37:26,054
So there's no point in me just
leaving work on time today, right?

725
00:37:26,054 --> 00:37:28,394
The whole point is I've gotta
try and leave on time every day.

726
00:37:28,874 --> 00:37:30,824
Um, and I might not be
able to do that right now.

727
00:37:30,824 --> 00:37:32,264
That might seem a way too much.

728
00:37:32,264 --> 00:37:34,874
And I still remember the
first day as a junior doctor.

729
00:37:35,234 --> 00:37:37,154
I'd been working I think
two or three years by then.

730
00:37:37,394 --> 00:37:40,664
But the first day that I left
work with something that I

731
00:37:40,664 --> 00:37:42,434
hadn't done on my to-do list.

732
00:37:42,854 --> 00:37:46,154
And I still remember that
day because it felt so awful.

733
00:37:46,334 --> 00:37:47,924
I felt like the worst doctor in the world.

734
00:37:47,924 --> 00:37:49,904
I felt like, you know, I was
gonna get into loads of trouble,

735
00:37:49,904 --> 00:37:51,914
I felt so anxious, but I did it.

736
00:37:52,274 --> 00:37:53,144
And that's the point.

737
00:37:53,144 --> 00:37:54,884
I think it's about doing something.

738
00:37:54,884 --> 00:37:58,692
So it's not so much like how do
I do this, but what, what could

739
00:37:58,902 --> 00:38:01,962
I do that is something small
that is actually achievable?

740
00:38:02,442 --> 00:38:06,731
Rather than it being like the fantasizing,
like, a New Year's resolution style,

741
00:38:06,731 --> 00:38:09,581
kind of like, I'm gonna eat healthy
every day and I'm gonna, you know,

742
00:38:09,581 --> 00:38:11,141
go for a run three times a week.

743
00:38:11,141 --> 00:38:14,471
And it's like, well, you know,
actually I, maybe that's not realistic.

744
00:38:14,711 --> 00:38:17,821
But could I have a five minute break?

745
00:38:18,151 --> 00:38:20,731
Whereas normally I wouldn't
have any break at all.

746
00:38:21,181 --> 00:38:21,691
Yeah, okay.

747
00:38:21,691 --> 00:38:22,921
I could do five minutes.

748
00:38:23,431 --> 00:38:23,641
Yeah.

749
00:38:23,641 --> 00:38:26,191
So I would say it's the what,
not the, how do I do this?

750
00:38:26,191 --> 00:38:27,361
It's what, what, could I do?

751
00:38:27,496 --> 00:38:27,916
I like that.

752
00:38:27,916 --> 00:38:30,256
And, and take just the little
thing says, yes, five minute

753
00:38:30,256 --> 00:38:33,916
breaks and maybe it's five minute
breaks, not in front of your desk.

754
00:38:34,416 --> 00:38:37,626
Could you go outside for five
minutes and stand under a tree?

755
00:38:38,526 --> 00:38:38,949
You know?

756
00:38:38,949 --> 00:38:39,159
Yeah.

757
00:38:39,189 --> 00:38:41,469
'cause that's practicing
the permission, right?

758
00:38:41,469 --> 00:38:43,689
You're practicing giving
yourself the permission to do it.

759
00:38:43,689 --> 00:38:46,029
The actual, what you're doing
isn't so important as the

760
00:38:46,029 --> 00:38:47,662
practicing doing it at all,

761
00:38:48,201 --> 00:38:50,871
What roles are other
people have in all of this?

762
00:38:50,871 --> 00:38:55,121
Because in my own life I found the
weirdest things have given me permission.

763
00:38:55,121 --> 00:38:59,491
I was talking to an author, she'd
written an amazing book, and I said to

764
00:38:59,491 --> 00:39:00,541
her, so when do you do your thinking?

765
00:39:00,541 --> 00:39:04,261
She said, well, every day I go and sit
in the sauna for an hour and I think.

766
00:39:04,261 --> 00:39:05,961
I'm like, oh my gosh.

767
00:39:05,961 --> 00:39:08,121
You know, like, I love soreness, but.

768
00:39:08,621 --> 00:39:09,911
It then gave me permission.

769
00:39:10,331 --> 00:39:13,601
I'm afraid I would love to go and sit
this order for an hour every, every day.

770
00:39:13,721 --> 00:39:16,901
Didn't manage to see that, but
even 20 minutes once a week,

771
00:39:17,201 --> 00:39:18,551
I'm like, I've got permission.

772
00:39:18,551 --> 00:39:22,661
'cause that person I really respected,
who's written this amazing book, and they

773
00:39:22,661 --> 00:39:24,731
told me about how it helps them think.

774
00:39:24,731 --> 00:39:27,881
And I was like, oh, well,
if they can do it, so can I.

775
00:39:27,881 --> 00:39:31,331
And then you suddenly find out about
a colleague that does go off, you

776
00:39:31,331 --> 00:39:34,781
know, at lunchtime and go out of
the hospital and, and go for a walk.

777
00:39:34,781 --> 00:39:36,911
Or even go for, oh, that person.

778
00:39:37,211 --> 00:39:37,541
Hang on.

779
00:39:37,541 --> 00:39:40,181
How did, did someone give a
memo out that I didn't see that

780
00:39:40,181 --> 00:39:41,941
says you're allowed to do that?

781
00:39:41,941 --> 00:39:44,281
It's always like finding your
own little memo, isn't it?

782
00:39:44,511 --> 00:39:48,501
Yeah, that's the second big tip I was
gonna give actually, is look for the

783
00:39:48,501 --> 00:39:50,061
people that can role model it for you.

784
00:39:50,451 --> 00:39:52,851
So we are often looking around and
seeing the people that aren't leaving

785
00:39:52,851 --> 00:39:55,611
on time or aren't having the breaks,
you know, or are just kind of martyring

786
00:39:55,611 --> 00:39:57,111
themselves, you know, like we are.

787
00:39:57,441 --> 00:40:01,101
But really look for those people
where it's like, oh, they've done

788
00:40:01,101 --> 00:40:02,541
this well, they've done that.

789
00:40:02,601 --> 00:40:05,091
Yeah, so although it's about you
giving yourself permission, it's

790
00:40:05,091 --> 00:40:09,171
perfectly reasonable and normal to
want to have seen someone else do it.

791
00:40:09,171 --> 00:40:11,301
You know, there's that phrase,
you can't be what you can't see.

792
00:40:11,801 --> 00:40:15,551
And so it's, so I would look for
those people, like actively look

793
00:40:15,551 --> 00:40:18,221
for the examples of the people in
your profession, in your specialty,

794
00:40:18,221 --> 00:40:21,971
at your grade that are doing those
things and do what they're doing.

795
00:40:22,243 --> 00:40:23,983
What if you can't find any role models?

796
00:40:24,233 --> 00:40:26,873
You know, I think we are lucky enough
to live in a world where we are really

797
00:40:26,873 --> 00:40:32,093
connected, obviously through the internet,
and, and actually there's always someone

798
00:40:32,280 --> 00:40:35,580
you know, Google it ChatGPT it, there's
always somebody who can give you an

799
00:40:35,580 --> 00:40:37,020
example of the thing that you want to do.

800
00:40:37,520 --> 00:40:38,510
Do you wanna leave medicine?

801
00:40:38,540 --> 00:40:40,520
There's loads of people out
there that have left medicine.

802
00:40:40,640 --> 00:40:41,870
Do you want to go part-time?

803
00:40:41,900 --> 00:40:45,260
There's literally millions of
people that have gone part-time.

804
00:40:45,260 --> 00:40:47,000
Like there's always gonna be someone.

805
00:40:47,120 --> 00:40:50,273
So you might have to look a
little harder than a minute or

806
00:40:50,273 --> 00:40:52,043
two, but you will find someone.

807
00:40:52,043 --> 00:40:53,393
Ask around as well.

808
00:40:53,693 --> 00:40:56,183
But I think it starts with you getting
clear about what it is you want.

809
00:40:56,183 --> 00:40:57,863
And that goes back to
that permission to be you.

810
00:40:58,363 --> 00:41:01,453
So often some people are kind
of struggling, but they're not

811
00:41:01,453 --> 00:41:03,553
really sure what's going on and
they're looking at other people

812
00:41:03,553 --> 00:41:04,573
and think, oh, do I wanna do this?

813
00:41:04,573 --> 00:41:05,263
Do I wanna do that?

814
00:41:05,263 --> 00:41:08,113
And they're sort of fantasizing
and escaping into other

815
00:41:08,113 --> 00:41:09,493
ideas and possibilities.

816
00:41:09,493 --> 00:41:13,033
And, and as I just say, just stop
for a moment and just check in.

817
00:41:13,243 --> 00:41:15,133
Like what is it you really need right now?

818
00:41:15,133 --> 00:41:18,683
And often it's actually something a
bit more, like, normal day to day.

819
00:41:19,163 --> 00:41:22,793
Like, you're tired, you need an early
night, or you know, you're thirsty,

820
00:41:22,793 --> 00:41:25,673
you need a drink, or you're a bit
lonely, you need to chat with a friend.

821
00:41:25,888 --> 00:41:29,788
So sometimes the permissions
aren't these big things.

822
00:41:30,001 --> 00:41:34,051
they're actually those little
day-to-day, moment to moment things

823
00:41:34,201 --> 00:41:37,576
that help us to stay well and connected
to ourselves and our own needs.

824
00:41:37,917 --> 00:41:40,677
I think asking a friend
is really helpful as well.

825
00:41:40,977 --> 00:41:42,807
You know, like, I've got this conundrum.

826
00:41:42,807 --> 00:41:43,737
What do you think I should do?

827
00:41:43,737 --> 00:41:48,055
And they'll often say, why is
this even a conundrum for you?

828
00:41:48,087 --> 00:41:49,377
It's really obvious.

829
00:41:49,377 --> 00:41:52,287
And actually you weren't asking them
'cause you didn't know what to do.

830
00:41:52,287 --> 00:41:57,537
You were asking their, what they thought
so that they would give you permission.

831
00:41:57,537 --> 00:42:00,657
And actually, I had a conversation with
some really good friends the other day.

832
00:42:00,657 --> 00:42:03,087
I said, look, I'm feeling
really guilty about something.

833
00:42:03,087 --> 00:42:05,237
It's something, nothing to do with my job.

834
00:42:05,237 --> 00:42:07,817
It's something to do with what
we were doing on a, on a trip.

835
00:42:08,087 --> 00:42:10,007
We're going on in a, in
a couple of months time.

836
00:42:10,007 --> 00:42:12,497
I said, I just need permission
not to do this one thing.

837
00:42:12,997 --> 00:42:14,407
And they talked to me about it.

838
00:42:14,407 --> 00:42:17,247
And actually I was asking for
them permission to not do it.

839
00:42:17,247 --> 00:42:19,147
They, they ended up talking about,
well, what's the issue with it and

840
00:42:19,147 --> 00:42:21,337
why is it you want, and actually
I'm gonna do that thing, but I'm

841
00:42:21,337 --> 00:42:23,257
gonna make it really nice for me.

842
00:42:23,757 --> 00:42:27,177
Um, and so just talking it
through was so, so helpful.

843
00:42:27,177 --> 00:42:30,747
Otherwise, you're trying to solve this
on your own and you are, it's very hard,

844
00:42:30,747 --> 00:42:34,707
I think, when you're thinking things
through on your own to identify those

845
00:42:34,707 --> 00:42:38,307
little gremlins that are whispering
the shame and guilt stories in your, in

846
00:42:38,307 --> 00:42:40,347
your ear because you've normalized them.

847
00:42:40,847 --> 00:42:43,157
And when you say them out loud, it helps.

848
00:42:43,187 --> 00:42:45,287
And then when you say to
someone else, it really helps.

849
00:42:45,287 --> 00:42:48,137
'Cause they're like, excuse
me, what did you just say you

850
00:42:48,137 --> 00:42:49,307
think you ought to be doing?

851
00:42:49,757 --> 00:42:51,497
Who says and why?

852
00:42:51,497 --> 00:42:54,857
And what sort of, either savior are you
anyway, or Really the other person's

853
00:42:54,857 --> 00:42:56,117
not gonna care that much, Rachel?

854
00:42:56,232 --> 00:42:58,692
Yeah, and I think this is where
coaching can be really helpful as well.

855
00:42:58,722 --> 00:43:01,692
Like friends can be great 'cause as
you say, they can mirror back to you.

856
00:43:01,692 --> 00:43:03,672
They've got their own thoughts,
they know you really well.

857
00:43:04,002 --> 00:43:07,242
Um, but also like having a conversation
with a coach can be great 'cause

858
00:43:07,242 --> 00:43:11,442
it, again, it just a space to hear
yourself say it out loud and to come

859
00:43:11,442 --> 00:43:14,742
to an understanding that you might
not have seen otherwise, you know?

860
00:43:14,742 --> 00:43:18,702
So quite often I'll be working with, um,
a doctor in coaching and they'll come for

861
00:43:18,702 --> 00:43:21,522
a session and they'll say, I wanna try
and make this big decision in my life.

862
00:43:21,612 --> 00:43:24,072
And I'll say, do you know what
the, you know, do you know what

863
00:43:24,072 --> 00:43:25,122
decision you've made already?

864
00:43:25,122 --> 00:43:28,962
And honestly, about eight times outta
10, they've already made the decision.

865
00:43:29,462 --> 00:43:34,232
So all they needed was that permission
to say, yeah, actually I do know.

866
00:43:34,682 --> 00:43:36,212
I heard someone say once.

867
00:43:36,212 --> 00:43:39,482
I think it was on a, a motivational
interview or whatever, he was saying

868
00:43:39,482 --> 00:43:43,412
that his coach had said to him,
stop pretending to be confused.

869
00:43:43,912 --> 00:43:47,452
You know exactly what you want to
do and you need to do, but you're

870
00:43:47,452 --> 00:43:49,852
finding it too hard to do it and
there's something stopping you.

871
00:43:49,852 --> 00:43:50,812
Let's talk about that.

872
00:43:50,872 --> 00:43:51,922
Not about the decision.

873
00:43:52,849 --> 00:43:54,379
Don't say I'm confused
about what I should do.

874
00:43:54,409 --> 00:43:55,789
'Cause actually, you
know what you should do.

875
00:43:55,789 --> 00:43:59,659
And I think a lot of us, we know, we
know it, but we feel confused 'cause

876
00:43:59,659 --> 00:44:02,269
it just, it just feels too hard.

877
00:44:02,519 --> 00:44:04,079
And that's coming back to the feelings.

878
00:44:04,079 --> 00:44:06,449
And I think that's why this
first book about permission

879
00:44:06,449 --> 00:44:07,649
is really about the feelings.

880
00:44:07,649 --> 00:44:11,489
It's like permission to feel confused,
permission to feel scared as well.

881
00:44:11,489 --> 00:44:14,849
It's so often when we're, we are
making a change in our behavior,

882
00:44:15,059 --> 00:44:18,419
particularly around our wellbeing
at work, it can be really scary.

883
00:44:18,419 --> 00:44:20,519
We are thinking, oh, what's
everyone gonna think of me?

884
00:44:20,519 --> 00:44:25,199
And you know, what's gonna happen
and, oh, um, so, but that's okay.

885
00:44:25,589 --> 00:44:27,119
You know, feelings aren't gonna kill us.

886
00:44:27,539 --> 00:44:28,709
They're not gonna hurt us.

887
00:44:28,709 --> 00:44:31,169
They're not comfortable, but
they actually go pretty quickly.

888
00:44:31,409 --> 00:44:32,579
Once we do the thing.

889
00:44:32,639 --> 00:44:35,759
Particularly if it's fear, it
tends to dissipate pretty quickly.

890
00:44:36,209 --> 00:44:41,179
So I'd say, yeah, permission to feel the
feelings that come up when you are, when

891
00:44:41,179 --> 00:44:44,659
you're making these choices, when you
are, you are changing these behaviors,

892
00:44:45,079 --> 00:44:46,729
um, the feelings will come and go.

893
00:44:46,886 --> 00:44:48,266
No feeling ever stays forever.

894
00:44:48,454 --> 00:44:50,146
I've got a bit of a yes, but Caroline.

895
00:44:50,326 --> 00:44:53,836
I've got a little voice in my head
going, the problem is here that what

896
00:44:53,836 --> 00:44:56,596
if I do take some time for self care.

897
00:44:56,596 --> 00:45:00,646
What if I do leave on time and somebody
else doesn't like it and I get pushback

898
00:45:01,006 --> 00:45:04,426
and they actually give me some grief
about and say, no, hang on a sec, you,

899
00:45:04,666 --> 00:45:06,226
that's not what's supposed to happen.

900
00:45:06,586 --> 00:45:07,846
Um, who do you think you are?

901
00:45:08,026 --> 00:45:10,486
They either tell you you're
being unprofessional or a

902
00:45:10,486 --> 00:45:12,166
bad parent or, you know.

903
00:45:12,716 --> 00:45:16,406
Then you've not only got your internal
voice telling you you're a dreadful

904
00:45:16,406 --> 00:45:22,389
person, you've actually got it confirmed
by that person who is either insinuating,

905
00:45:22,389 --> 00:45:26,199
maybe it's more insinuating stuff, but
sometimes they genuinely push back to you.

906
00:45:26,449 --> 00:45:27,229
Oh, totally.

907
00:45:27,229 --> 00:45:31,309
I, I tell a story in my book on this where
a, I was at a sickness review meeting.

908
00:45:31,309 --> 00:45:33,049
I'd had three days off sick.

909
00:45:33,439 --> 00:45:36,529
Um, and it had triggered a signature
review meeting and my consultant

910
00:45:36,529 --> 00:45:40,354
said, doctors shouldn't take
sick leave ' cause it's selfish.

911
00:45:40,452 --> 00:45:41,412
Actually said that?

912
00:45:41,468 --> 00:45:41,918
Yes.

913
00:45:41,948 --> 00:45:43,928
Actually said that in a
sickness review meeting.

914
00:45:43,928 --> 00:45:44,228
I know.

915
00:45:44,528 --> 00:45:45,188
Unbelievable.

916
00:45:45,188 --> 00:45:45,428
Right?

917
00:45:45,428 --> 00:45:48,848
So like jaw dropping, you think, hang
on, that can't possibly have happened.

918
00:45:49,238 --> 00:45:51,428
But it did and it does exist
and you are absolutely right.

919
00:45:51,428 --> 00:45:52,448
It exists blatantly.

920
00:45:52,448 --> 00:45:53,978
People say those things to each other.

921
00:45:54,188 --> 00:45:55,748
And patients say those things.

922
00:45:55,748 --> 00:45:59,138
I talk to GPS all the time where
patients are like angry that they

923
00:45:59,138 --> 00:46:02,078
couldn't get an appointment even though
they knew the doctor was all sick.

924
00:46:02,528 --> 00:46:02,768
You know?

925
00:46:02,888 --> 00:46:03,788
So it happens.

926
00:46:03,788 --> 00:46:04,538
It is out there.

927
00:46:04,538 --> 00:46:07,718
There is a reality that when we
change our behavior, other people

928
00:46:07,718 --> 00:46:09,578
can react and they can react badly.

929
00:46:10,078 --> 00:46:12,868
So let me turn the question around to
you Rachel if it's alright to do that.

930
00:46:12,868 --> 00:46:14,758
Like, what would you do if that happened?

931
00:46:14,998 --> 00:46:18,748
Past Rachel probably would've beat
her, beaten herself up for days.

932
00:46:19,288 --> 00:46:22,718
New Rachel or evolving Rachel
probably would note it.

933
00:46:23,138 --> 00:46:25,598
I would note the guilt and
the shame I was feeling.

934
00:46:26,025 --> 00:46:29,445
And I think nowadays, having done a lot
of work with you in our Permission to

935
00:46:29,445 --> 00:46:33,365
Thrive community and all my wonderful
guests on the podcast I would probably

936
00:46:33,365 --> 00:46:36,605
try, first of all, feel it, feel it,
rather than try and explain it away.

937
00:46:36,605 --> 00:46:38,555
I would try and go, oh, what am I feeling?

938
00:46:38,555 --> 00:46:39,485
I'm feeling shame.

939
00:46:39,485 --> 00:46:40,775
I'm feeling this way.

940
00:46:40,775 --> 00:46:42,125
Telling me you're a bad person.

941
00:46:42,125 --> 00:46:43,355
They're absolutely right.

942
00:46:43,638 --> 00:46:45,168
Well I would talk to someone about it.

943
00:46:45,168 --> 00:46:49,298
'Cause like we always say like,
shame can't survive being spoken.

944
00:46:49,798 --> 00:46:53,448
Share it but also, no,
it's, it's not mine, but.

945
00:46:53,948 --> 00:46:57,678
Even if you have caused someone else a
few problems, and even if you are being

946
00:46:57,678 --> 00:47:02,088
selfish, 'cause actually in order to
practice necessary care, don't call itself

947
00:47:02,088 --> 00:47:04,308
care anymore, you have to be selfish.

948
00:47:04,578 --> 00:47:08,265
But we, we've decided in, our
profession, being selfish is one of the

949
00:47:08,265 --> 00:47:10,185
worst crimes you could possibly have.

950
00:47:10,665 --> 00:47:14,235
And I think I've learned to start
telling myself, you know, well, okay,

951
00:47:14,325 --> 00:47:15,615
of course you're feeling like that.

952
00:47:15,615 --> 00:47:18,765
Of course you're feeling guilty
and awful and shame because look

953
00:47:18,765 --> 00:47:21,165
what you've grown up with, but
look what you're dealing with.

954
00:47:21,285 --> 00:47:22,965
So of course you're gonna feel like that.

955
00:47:22,965 --> 00:47:25,485
So it's this whole trying to recognize it.

956
00:47:25,545 --> 00:47:27,675
Like you were saying,
guilt is just a, a sign.

957
00:47:27,675 --> 00:47:28,575
You're not a psychopath.

958
00:47:28,785 --> 00:47:32,945
It's a sign that you wish you had
unlimited time, energy, and capacity, but

959
00:47:33,005 --> 00:47:37,725
you don't, but you still feel, it doesn't
stop those feelings from happening.

960
00:47:37,725 --> 00:47:38,498
And I, I think

961
00:47:38,498 --> 00:47:41,378
It doesn't, and they're not comfortable
feelings, don't get me wrong.

962
00:47:41,378 --> 00:47:42,278
And do you know what?

963
00:47:42,278 --> 00:47:45,068
I wish I had a magic wand that
I could wave and nobody ever

964
00:47:45,128 --> 00:47:46,718
had to feel shame ever again.

965
00:47:47,108 --> 00:47:50,228
But it's a really common,
normal human emotion.

966
00:47:50,228 --> 00:47:54,668
And it often gets triggered when we
change our behavior in a way that

967
00:47:54,668 --> 00:47:58,628
kind of slightly unsettles other
people and they don't like it, so they

968
00:47:58,628 --> 00:48:01,688
might get a bit passive aggressive
or a bit whatever, and you get a

969
00:48:01,688 --> 00:48:05,468
sideways look or a little comment or,
yeah, and it's really uncomfortable.

970
00:48:05,858 --> 00:48:09,188
But I think we have to stay really
honest and true to ourselves.

971
00:48:09,188 --> 00:48:10,508
Like what do we really believe here?

972
00:48:11,008 --> 00:48:13,018
Do we believe that we're some
evil, horrible person that's

973
00:48:13,018 --> 00:48:14,128
done something horrendous?

974
00:48:14,578 --> 00:48:17,848
Or have we learn and do we believe that
actually there's shame that exists out

975
00:48:17,848 --> 00:48:21,268
there in the world, doesn't belong to
you or me, but it does a bit triggering.

976
00:48:21,778 --> 00:48:24,388
But if we feel it, we share,
it doesn't last forever.

977
00:48:24,838 --> 00:48:25,738
It passes.

978
00:48:26,218 --> 00:48:26,728
And you know what?

979
00:48:26,728 --> 00:48:29,548
You'll feel okay, because you
took that break or you took

980
00:48:29,548 --> 00:48:31,108
that day off or whatever it was.

981
00:48:31,608 --> 00:48:34,398
The alternative is we carry
on with that old story.

982
00:48:34,788 --> 00:48:38,058
We carry on, like you said at the
very beginning of this interview,

983
00:48:38,448 --> 00:48:40,728
you know, what happens if we
don't give ourselves permission?

984
00:48:40,728 --> 00:48:40,998
Why?

985
00:48:40,998 --> 00:48:45,638
You know how, and we carry on just
getting more and more tired, exhausted,

986
00:48:45,638 --> 00:48:50,888
stress burnt out, and it it's a road to
somewhere very, very bad and difficult.

987
00:48:50,918 --> 00:48:52,538
So this is important.

988
00:48:53,038 --> 00:48:56,298
It's important that we tolerate
those little blips, those

989
00:48:56,298 --> 00:48:57,678
little reactions from others.

990
00:48:58,178 --> 00:49:01,898
They do settle down and
sometimes magical things happen.

991
00:49:02,258 --> 00:49:05,558
Like, I love it when I hear from doctors,
they say, oh, I, I just went home on

992
00:49:05,558 --> 00:49:09,688
time, and then the next day, like four
of us went home on time, or you know,

993
00:49:09,688 --> 00:49:11,308
well, we all went for lunch together.

994
00:49:11,308 --> 00:49:14,938
Or, or I told someone that I'd gone to
speak to someone at Practitioner health

995
00:49:14,938 --> 00:49:18,828
and then now they've gone to see them and
they're feeling a lot better and it starts

996
00:49:18,828 --> 00:49:20,718
to spread in a really positive direction.

997
00:49:20,968 --> 00:49:23,128
Yeah, in an ideal word, no
one would ever feel shame.

998
00:49:23,353 --> 00:49:25,503
At all in the real world.

999
00:49:25,713 --> 00:49:26,223
We do.

1000
00:49:26,223 --> 00:49:30,323
And I think sometimes I've tried to
either explain away shame so that I

1001
00:49:30,323 --> 00:49:33,233
don't feel it, so you, you are wrong,
and unless you change your mind and

1002
00:49:33,233 --> 00:49:36,413
you agree with what I've done or
whatever, that's not gonna be okay.

1003
00:49:36,443 --> 00:49:39,473
Or I've tried to do so much work
on myself and change my stories

1004
00:49:39,473 --> 00:49:41,183
that I don't feel shame anymore.

1005
00:49:41,483 --> 00:49:44,123
I actually think half the time
it's going, oh look, there's shame.

1006
00:49:44,373 --> 00:49:44,733
Yeah.

1007
00:49:44,853 --> 00:49:46,803
And my shame's been
triggered and that's okay.

1008
00:49:46,833 --> 00:49:47,703
It's not gonna kill me.

1009
00:49:47,703 --> 00:49:48,303
It's horrible.

1010
00:49:48,303 --> 00:49:48,843
Don't get me wrong.

1011
00:49:49,023 --> 00:49:52,623
My shame triggers used to last days
to weeks and they were horrendous.

1012
00:49:52,713 --> 00:49:56,433
Now they last maybe a few minutes
to a few hours at the worst.

1013
00:49:56,763 --> 00:49:59,523
But I like you, I know to
notice it, name it, and talk

1014
00:49:59,523 --> 00:50:01,083
about it with a trusted other.

1015
00:50:01,583 --> 00:50:04,523
Um, and it does go, and I do
realize that, oh, hang on.

1016
00:50:04,523 --> 00:50:05,513
I'm not a bad person.

1017
00:50:05,669 --> 00:50:06,614
You're a human being, right?

1018
00:50:07,313 --> 00:50:09,563
I was reading somewhere that
actually if you have a friend that's

1019
00:50:09,563 --> 00:50:11,723
totally perfect and they've done
anything wrong, you are not friends

1020
00:50:11,723 --> 00:50:12,863
with them for very long, right?

1021
00:50:12,983 --> 00:50:16,463
Because they're a really,
really boring, and b, no.

1022
00:50:16,657 --> 00:50:17,287
had a friend like that?

1023
00:50:17,287 --> 00:50:18,187
Sorry, I've never had a

1024
00:50:18,233 --> 00:50:19,973
you of course, obviously you're Perfect.

1025
00:50:20,025 --> 00:50:20,723
apart from me.

1026
00:50:21,573 --> 00:50:24,696
But no, I mean because like they
just seem just so good and you're

1027
00:50:24,696 --> 00:50:27,546
like constantly thinking, oh God,
they're so good, aren't they?

1028
00:50:27,546 --> 00:50:27,756
They're so

1029
00:50:28,036 --> 00:50:28,256
oh,

1030
00:50:28,296 --> 00:50:28,806
amazing.

1031
00:50:28,881 --> 00:50:29,211
Yep.

1032
00:50:29,226 --> 00:50:29,796
here's me.

1033
00:50:30,296 --> 00:50:31,046
But they're not right.

1034
00:50:31,046 --> 00:50:33,986
You know, that is the wonderful
thing about being a, a doctor

1035
00:50:34,046 --> 00:50:34,886
or a high stress professional.

1036
00:50:35,066 --> 00:50:38,876
You can't be in a job like that without
seeing real human, like, behavior.

1037
00:50:38,876 --> 00:50:41,126
And like, we've all seen it, haven't we?

1038
00:50:41,126 --> 00:50:42,536
In ourselves and in others.

1039
00:50:42,536 --> 00:50:45,476
Like, you know, we've all had bad
days and not been on our best.

1040
00:50:45,476 --> 00:50:47,205
And that is the human condition.

1041
00:50:47,205 --> 00:50:49,665
So again, it's permission to
feel whatever you're feeling.

1042
00:50:50,145 --> 00:50:51,015
It's okay.

1043
00:50:51,515 --> 00:50:55,025
You know, feel angry, feel shame,
feel guilt, feel it's all right.

1044
00:50:55,205 --> 00:50:58,835
Um, there's different things, little
tiny strategies and tips that can help.

1045
00:50:58,835 --> 00:51:01,235
And that's what's, you know,
partly what the book is about.

1046
00:51:01,625 --> 00:51:05,165
Um, that certain things can help
a bit more uncertain with certain

1047
00:51:05,165 --> 00:51:09,945
feelings, but ultimately it's about
it's okay to feel what you're feeling.

1048
00:51:10,134 --> 00:51:13,289
And it's okay to be human and
that's what makes life worth living.

1049
00:51:13,289 --> 00:51:17,310
But I read a quote the other day saying
that burnout is what happens where you

1050
00:51:17,310 --> 00:51:19,470
try and avoid being human for too long.

1051
00:51:19,699 --> 00:51:20,648
I like that.

1052
00:51:20,648 --> 00:51:21,158
Yeah.

1053
00:51:21,398 --> 00:51:25,950
We often talk about, um, stretching
our limits and wonderful questions that

1054
00:51:25,950 --> 00:51:27,540
can make us think anything is possible.

1055
00:51:27,540 --> 00:51:29,760
But actually I think
it's a balance, isn't it?

1056
00:51:29,760 --> 00:51:34,610
Between anything is possible and
also recognizing our human limits.

1057
00:51:34,610 --> 00:51:36,440
And we all need rest.

1058
00:51:36,440 --> 00:51:40,580
We all need, you know, some love and
connection and someone telling us

1059
00:51:40,580 --> 00:51:42,290
it's gonna be all right, you know?

1060
00:51:42,320 --> 00:51:48,220
We all need food and drink and, um,
and we all say and do stuff that

1061
00:51:48,220 --> 00:51:51,768
we wish we hadn't, and we all make
mistakes and we're all gonna have

1062
00:51:51,768 --> 00:51:53,598
our shame triggered at some point.

1063
00:51:53,868 --> 00:51:58,248
And I think learning to deal with our
shame in a healthy way is one of the

1064
00:51:58,248 --> 00:52:01,758
most important professional things you
can do, and personal things you can

1065
00:52:01,758 --> 00:52:06,042
do, because as we can see on the world
stage, when people's shame is triggered,

1066
00:52:06,042 --> 00:52:07,992
they behave really, really badly.

1067
00:52:08,242 --> 00:52:11,662
I don't behave very well When I'm
feeling shameful, I try and make it

1068
00:52:11,662 --> 00:52:14,962
someone else's shameful try, you know,
trying to get, do anything to make

1069
00:52:14,962 --> 00:52:18,622
it so it's not me or, or whatever,
and I'm not a very nice person, so,

1070
00:52:18,622 --> 00:52:20,451
Become like a spiky hedgehog, right?

1071
00:52:21,207 --> 00:52:24,327
You're lovely and soft on the
underbelly, but as soon as you're

1072
00:52:24,327 --> 00:52:25,827
frame trigger, it's like spiky.

1073
00:52:25,887 --> 00:52:26,937
It's a big spiky ball.

1074
00:52:27,053 --> 00:52:29,063
I think that's what's
happening in, in healthcare.

1075
00:52:29,063 --> 00:52:32,023
You know, when people are talking about
the, their colleagues who are behaving

1076
00:52:32,023 --> 00:52:35,683
abysmally, you know, and I'm thinking,
gosh, are these the same doctors that

1077
00:52:35,683 --> 00:52:37,153
I used to know or have you thinking?

1078
00:52:37,153 --> 00:52:40,953
It's because they're all so overwhelmed
and feeling ashamed that they can't

1079
00:52:41,073 --> 00:52:44,733
do ev everything and feeling really
pissed off and defensive and it's just

1080
00:52:44,763 --> 00:52:47,583
becomes a big spiky ball of spike.

1081
00:52:47,691 --> 00:52:51,171
Everyone's spiking everybody else
rather than just going, let's just

1082
00:52:51,671 --> 00:52:55,421
talk to each other and admit we're
human and see what we can do.

1083
00:52:55,421 --> 00:53:00,841
And if I'm feeling over responsible for
someone else, I am gonna feel really

1084
00:53:00,841 --> 00:53:05,091
pissed off when they put in boundaries
and want to practice self-care.

1085
00:53:05,091 --> 00:53:07,791
'Cause I will automatically
think that impacts on me.

1086
00:53:08,280 --> 00:53:11,160
Um, and I, I, I see that in a lot
of senior healthcare pressures.

1087
00:53:11,250 --> 00:53:13,350
Boy, I see that in a lot
of my family members.

1088
00:53:13,350 --> 00:53:16,650
They're so over responsible, such a
rescuer, they get really annoyed when they

1089
00:53:16,650 --> 00:53:18,150
see other people making bad decisions.

1090
00:53:18,150 --> 00:53:20,160
'cause they think, well now I'm
gonna have to go and rescue them.

1091
00:53:20,820 --> 00:53:22,110
No, don't do it.

1092
00:53:22,110 --> 00:53:22,710
Stay away.

1093
00:53:22,957 --> 00:53:25,717
That's a big theme that's come out
of me from our chat today actually,

1094
00:53:25,717 --> 00:53:30,701
is around codependency and how we,
we so often as, as doctors and caring

1095
00:53:30,701 --> 00:53:34,514
professionals, will take care of
others and that gets unhealthy, right?

1096
00:53:34,514 --> 00:53:37,334
We're taking responsibility for
how they feel, for what they're

1097
00:53:37,334 --> 00:53:39,314
saying and doing, and it's not ours.

1098
00:53:39,614 --> 00:53:40,604
It's not our responsibility.

1099
00:53:40,604 --> 00:53:44,134
It's our responsibility to look
after ourselves, to look after our

1100
00:53:44,134 --> 00:53:48,154
emotional response and our decisions
and our choices, not theirs, right?

1101
00:53:48,154 --> 00:53:52,164
It's like your zone of control, your
zone of power, you know, and a lot of

1102
00:53:52,164 --> 00:53:56,784
this comes down to that permission to,
to let go a little bit of what other

1103
00:53:56,784 --> 00:53:58,764
people are thinking and saying and doing.

1104
00:53:59,014 --> 00:54:03,040
And I've realized recently that actually
people pleasing, someone said this to me,

1105
00:54:03,040 --> 00:54:04,570
that hit me like a brick between the eyes.

1106
00:54:04,870 --> 00:54:07,720
People pleasing is not me being nice.

1107
00:54:07,720 --> 00:54:10,150
It's me trying to control
someone else's opinion of me.

1108
00:54:10,452 --> 00:54:11,052
A hundred percent.

1109
00:54:11,552 --> 00:54:16,052
on that note, Caroline, let's, um,
it's been, you know, there's, there's

1110
00:54:16,052 --> 00:54:19,112
so much more we can, we can talk about
permission and I think one of the things

1111
00:54:19,112 --> 00:54:23,552
that we have seen is getting a community
of people together to explore all this

1112
00:54:23,702 --> 00:54:27,242
together about like, what is it that you
actually need to be able to work at your

1113
00:54:27,242 --> 00:54:32,942
best, to be able to be who you are, be
authentically yourself, whether you think

1114
00:54:33,442 --> 00:54:37,804
in a neurotypical way or a neurodivergent
way, like what is it that I need in order

1115
00:54:37,804 --> 00:54:41,464
to give my best to work for my patients
and for my colleagues and for my team

1116
00:54:41,464 --> 00:54:42,784
members and all that sort of thing.

1117
00:54:42,784 --> 00:54:46,144
And getting people together to actually
plan it, to connect, to share some of

1118
00:54:46,144 --> 00:54:49,924
these shame stories we've got going
wrong has been incredibly powerful.

1119
00:54:49,924 --> 00:54:54,364
And that's what we've seen in, in
Permission to Thrive our, um, personal

1120
00:54:54,364 --> 00:54:56,224
development community for doctors.

1121
00:54:56,224 --> 00:54:59,104
So if you're interested in that, do
check out the links in the show notes.

1122
00:54:59,608 --> 00:55:02,188
But before we go, Caroline, what
would your top three tips be?

1123
00:55:02,608 --> 00:55:04,288
You've written a whole book
on this, so I'm asking you to

1124
00:55:04,288 --> 00:55:06,058
distill it into just three tips.

1125
00:55:06,558 --> 00:55:12,868
I think, uh, number one, give yourself
permission, emphasis on the yourself.

1126
00:55:13,368 --> 00:55:15,798
Number two, give yourself
permission to be you.

1127
00:55:16,298 --> 00:55:17,318
Emphasis on the you.

1128
00:55:17,818 --> 00:55:20,548
I'd love to make the third one
sound like it fits in with those,

1129
00:55:20,548 --> 00:55:25,648
but I'm making this up as I go,
so I'll tell you what, uh, yeah.

1130
00:55:25,648 --> 00:55:28,608
Permission not to do things well.

1131
00:55:28,903 --> 00:55:30,343
to permission To fail.

1132
00:55:30,756 --> 00:55:33,576
I heard someone once said, um,
everyone needs to have something.

1133
00:55:33,576 --> 00:55:34,596
They're really mediocre at.

1134
00:55:35,096 --> 00:55:36,176
I was like, brilliant.

1135
00:55:36,326 --> 00:55:37,706
That really helped me with my tennis.

1136
00:55:38,036 --> 00:55:38,246
Yeah.

1137
00:55:38,746 --> 00:55:40,606
But I was like, I've gotta be really good.

1138
00:55:40,606 --> 00:55:42,346
And I'm like, I'm really
not very good, but yay.

1139
00:55:42,346 --> 00:55:45,496
This is, I'm really good at being
mediocre, so I'm still winning.

1140
00:55:47,360 --> 00:55:49,760
I obviously don't need any therapy
or anything about Caroline.

1141
00:55:50,209 --> 00:55:51,739
no, never crossed my mind

1142
00:55:51,955 --> 00:55:52,375
Lovely.

1143
00:55:52,375 --> 00:55:52,705
Right.

1144
00:55:52,825 --> 00:55:54,145
How can people get hold of your book?

1145
00:55:54,145 --> 00:55:55,765
How can people find out
more about what you do?

1146
00:55:55,765 --> 00:55:56,215
Caroline?

1147
00:55:56,300 --> 00:56:00,170
so they can find out about me at
joyfuldoctor.com and across social

1148
00:56:00,170 --> 00:56:04,070
media as the Joyful Doctor, um,
and the book is called Permission:

1149
00:56:04,070 --> 00:56:07,910
How to Feel, heal and Thrive in a
Challenging World, and it's available

1150
00:56:07,910 --> 00:56:10,010
via our website or on amazon now.

1151
00:56:10,201 --> 00:56:12,631
So thank you so much for
being with us, Caroline.

1152
00:56:12,631 --> 00:56:15,961
That's been really interesting,
really helpful for me.

1153
00:56:15,961 --> 00:56:19,561
And if people are interested, um,
if Caroline's work, check out,

1154
00:56:19,621 --> 00:56:22,351
check out the Permission to Thrive
community, you can come and try it out.

1155
00:56:22,421 --> 00:56:25,661
We have a, um, a money back guarantee
if you wanna come and try it.

1156
00:56:25,661 --> 00:56:27,341
If you don't like it, no worries at all.

1157
00:56:27,341 --> 00:56:29,321
But honestly, it's been
really transformative for,

1158
00:56:29,321 --> 00:56:30,491
for both of us, hasn't it?

1159
00:56:30,491 --> 00:56:31,841
And, and the people that are in it.

1160
00:56:32,033 --> 00:56:33,623
Oh, it's been amazing.

1161
00:56:33,623 --> 00:56:37,013
And like you said, just that chance
to come together with like-minded

1162
00:56:37,013 --> 00:56:40,703
people, a chance to stop, think
about what it is you need.

1163
00:56:40,763 --> 00:56:41,783
Yeah, absolutely.

1164
00:56:41,783 --> 00:56:42,533
Do come join us.

1165
00:56:42,533 --> 00:56:43,643
We'd love to see you there.

1166
00:56:43,643 --> 00:56:46,283
It's some of our favorite,
uh, mornings and evenings of

1167
00:56:46,283 --> 00:56:47,333
the year, isn't it, Rachel?

1168
00:56:47,333 --> 00:56:49,073
When we hang out with
our Permission to Thrive

1169
00:56:49,270 --> 00:56:49,644
We do it.

1170
00:56:49,649 --> 00:56:51,594
One, one thing that I found
powerful is because it's in the

1171
00:56:51,594 --> 00:56:54,594
diary regularly, you've already
given yourself permission to do it.

1172
00:56:54,594 --> 00:56:56,754
You've booked your study, leave
you, you, you do it regularly.

1173
00:56:56,754 --> 00:56:57,929
And I think that for me,

1174
00:56:58,398 --> 00:56:59,028
Absolutely.

1175
00:56:59,033 --> 00:56:59,958
Permission's baked

1176
00:57:00,110 --> 00:57:02,835
baked in permission, 'cause you've,
it's in the diary and once it's

1177
00:57:02,835 --> 00:57:04,335
in the diary, it's in there.

1178
00:57:04,335 --> 00:57:08,745
So yeah, if you wanna check that out, do
um, and, uh, thank you so much for being

1179
00:57:08,745 --> 00:57:10,455
with us and we'll talk to you again soon.

1180
00:57:10,705 --> 00:57:11,845
Thank you so much for having me.

1181
00:57:13,321 --> 00:57:14,251
Thanks for listening.

1182
00:57:14,351 --> 00:57:18,811
Don't forget, you can get extra bonus
episodes and audio courses along with

1183
00:57:18,901 --> 00:57:23,731
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1184
00:57:23,811 --> 00:57:28,271
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memberships to help busy professionals

1185
00:57:28,271 --> 00:57:31,241
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1186
00:57:31,614 --> 00:57:35,134
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